Depression

Four Ways To Make Next Year A Great Year

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Reach Your Goals/Change Your Life

It’s difficult to believe that 2018 is coming to a close. I’ll bet you remember when the year was still fresh. A clean slate to write upon. Yet now the year is quickly running to the finish line. Another chapter of life written.

Many of us use this time to reflect on memories of what went well, the successes we’ve had, times with family and friends, and the goals we’ve achieved.

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On the other hand, many of us also look at what we would like to have done differently. This can be a little painful. It might even cause some anxiety to look at those goals that were not reached. Things we promised ourselves we would finally complete, but once again somehow never got around to doing. (Spoiler alert… I’m going to show you how to move those painful items to the “Been there, done that” column of life).

All of this brings us to the topic of New Year’s resolutions.

With a new year stretched out before us, it’s natural to want to set ambitious goals. Important and personally meaningful goals. Often, without too much thought, we’ll latch onto a couple of things we would like to change in our life and then make a New Year resolution.

Sadly, by the middle of the year, most of us have broken these resolutions. I feel your pain. 

Yep, by the time the weather turns warm, most of us have tossed aside our New Year resolutions. Dumped them on the side of the road that leads to summer. Tossed them out the window as if they were some regrettable impulse buy made at the Dollar Tree store. (True confession, I’ve never regretted a Dollar Tree purchase – but that’s not the issue).

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Have you found yourself in that situation? The odds are you have – like most of us. Welcome to the club. But take a moment now to consider what might have happened if you had succeeded in fulfilling one or two of those resolutions? Better yet, what if you had been successful in keeping your resolutions over each of the past five years?

How might your life be different? In what ways could it be better? In what ways might you have become a better version of yourself? Really give that some thought.

Resolutions that are successful, even small resolutions, have the potential to dramatically change one’s life.

I recall the story of a woman in her 40’s who was depressed, overweight, socially isolated and a chain smoker. On a trip overseas, in a remote location, she found herself unable to buy cigarettes. For a full week she would be without her smokes.

“Why doesn’t Trip Advisor warn about such things!” she screamed into her pillow (OK, I added that, not sure the whole screaming into the pillow was part of her story).  

Bottom line, the woman was not pleased. Nicotine withdrawal is a bear.

But by the end of the week she had an insight. Despite her numerous attempts to stop smoking throughout the previous ten years, she had never gone a full week without a cigarette. Now that she had a full week of being clean, she wondered if she could extend that streak for one more day.

It wasn’t easy, but she stayed clean another day. Then another, and another, and another. By this point her confidence had soared, as had her determination to stay ‘nicotine sober.’

Having kicked cigarettes out of her life, she physically felt much better. Her sleep had improved. Her thinking was clearer. She began to savor the subtle flavors of food that had been dulled by a two pack a day habit.

So she decided to start exercising. Every morning began with a brisk walk. It wasn’t long before she was waking earlier and walking three miles a day. Then jogging, and then running.

Eventually she joined a running group. The other runners were warm and welcoming. Friendships formed.

Her friends encouraged her to sign up for a half marathon. They would run as a group. To prepare for the challenge she changed her eating habits. Due to all the running and healthier eating she began to lose weight.

All of these changes took place within two years of her having stopped smoking. A small change in her life had unforeseen consequences. It altered her outlook, and pushed her in a new direction.

Two years previously she had been unhappy, smoking two packs a day, in poor health, and had almost no real friends. Now she was the picture of health, supported by friends, and optimistic about the future.

The right changes, even small ones, can shift our lives in dramatically new directions. These changes are similar to the slight push on the tiller of a boat. This causes the rudder to move ever so slightly one way or another, changing course of direction just a few degrees.

What sort of difference do these small changes make? Well, if you were sailing north from the southern Pacific Ocean it would make the difference between making landfall on the coast of Russia, versus the United States.

New Year resolutions that are well chosen can have a similar impact on your life, drastically altering where you find yourself in the coming years.

Resolutions Are Goals

Resolutions are simply goals. And goals that we stick to have tremendous power because they change life’s trajectory. They have the punch to rekindle old passions. To unveil forgotten potential, and spark a cascade of positive change.

We all need goals. Better yet, we need good goals. Those that lead us to form habits which, having become second nature, move our life forward even when we are not consciously striving to do so.

One example of such a habit is that of getting consistently getting a good night’s sleep. Nail this habit and you will see a change in improved energy, a brighter mood, and a clearer mind. Or the habit of reading leads us to expand our knowledge and view the world with a more informed perspective.

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What we want to avoid are resolutions, or goals, that wither and die. These lead to a sense of frustration. Of being stuck. Powerless to change our own destiny.

Better to not make any New Year resolutions than to perpetually fail at keeping them. I know, sounds harsh. But there is no upside to going through an end of year ritual that teach us to expect failure.

The ‘take home’ message? Take aim at forming resolutions that you are willing to fully commit to fulfilling. Chose resolutions, no matter how small, that will enrich your life in some way.

When choosing a resolution think of a ‘why’ that makes it worth sacrificing time and energy to complete. The ‘why’ boils down to how it improves your life, or the lives of the people you most deeply care for.

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How To Make Resolutions That Stick  

So how do you stick to a New Year’s resolution?  

By building a strategy that supports your success at reaching the goal you have set. 

What’s that again? Let me elaborate.

Most resolutions are made with a great deal of sincerity, but very little detailed planning. To increase the odds of success, you need even more planning than sincerity. If a goal is not worth the time and effort needed to make a detailed plan for succeeding, then it is unlikely to be worth the even bigger effort it takes to reach that goal.

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There are four simple steps you can follow that will make reaching any goal much more likely. Each step requires some earnest thought.

This ‘thinking through the details’ of how to reach your goal can be challenging. But if you’re willing to put in the effort, the rewards are great.

Let’s go over each step.

ONE            Select a realistic goal. For example, if you want to learn a new language in the coming year, your goal might be to memorize three hundred words of that language. With that vocabulary having been built up you might also aim to have 50 different sentences with which you are fluent by the end of the year.

That boils down to learning six words a week, and about four sentences a month. How much of your time would that require each week? Thirty minutes? An hour at the most?

Much more doable than the loftier goal of learning to speak a foreign language fluently by the end of the year (sorry Rosetta Stone, but let’s deal with how much spare time most people really have each day). Learning 300 words, and 50 sentences is a realistic goal, even for a very busy person like you.

If you continued with that goal for several more years you would have at your command a vocabulary of well over a thousand words, and hundreds of sentences. That’s what they call pretty impressive in French  (assez impressionnant), German (ziemlich beeindruckend), or Japanese (Kanari inshō-teki). 

TWO           Write down each step that you must take in order to succeed. Using the same example, we could easily identify several steps: buy a book, or a DVD language set, or enroll in an online course. Another step would be to set aside the time to study each day. A third step would be to identify the words you wished to learn, put them on a list and determine what words will be learned each week. Another step would be to decide how to reinforce the learning once you’ve committed a word to memory (e.g., flash cards that would be reviewed once weekly). You get the idea.

It’s important to be specific with your plan. Likewise, it is important to be committed to the plan.

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For instance, if you planned to spend ten minutes on Monday, Wednesday and Friday evening reviewing the vocabulary words, you would mark that in your calendar. 

It would need to be treated as an important appointment with yourself. Keeping that appointment should be a priority.

Lastly, I need to emphasize that staying with your new routine will be difficult at first. But once you get started, and you’ve stayed with it for two or three months, it becomes second nature. Like brushing your teeth, just part of your routine.

THREE       Find a partner (if possible) to join you in reaching this goal. This will make it more fun, and you’ll have someone to encourage you, and help keep you on track.

FOUR         Reward yourself along the way. As you make progress toward reaching your goal, stop to celebrate. For the example about learning a language, it would be good to celebrate after every 50 words are mastered. That’s a milestone! Time for a pat on the back and a double scoop of ice cream!

Are there any other ways you can think of to make resolutions that stick? It’s worth giving some thought – it just might be the thing that sends your life in an entirely new and more rewarding direction.

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Three Unrealistic Beliefs That Create Anxiety And Depression… And How To Be Rid Of Them

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Beliefs That Hold You Back

I’ve listened to hundreds of men and women talk about their biggest fears and their most exciting triumphs. They have spoken about the things that bring the most joy into their lives, and that which creates clouds of discontent.

Through these privileged conversations, I have detected a common thread. A set of core of beliefs that lead to frustration and self-doubt. Conclusions that many people accept as basic truths about what needs to happen in life so that they can be happy. So they can be successful. That life can be richly enjoyed and filled with purpose.

When we rid ourselves of these unrealistic expectations, we become more receptive to the joys of life. We feel much freer. 

Let’s look at just three of these toxic beliefs and what can be done to reduce their influence.

Unrealistic Expectations

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One: “I have to reach some goal, possess some object, win someone’s approval. What’s more, that needs to happen right now! If I don’t succeed right away, then I cannot be truly happy.”

Solution: Keep in mind that no one succeeds in consistently meeting major life goals in the timeframe that they would like.

Impatience is an impediment to savoring the moment, a barrier to happiness.   

Many of us struggle with impatience: the feeling that we need to succeed RIGHT NOW in order to enjoy life. The first step to changing this unrealistic standard is to take a moment and recall those times when you failed to reach an important goal. It may have seemed that the world was crashing in on you. But, the fact is life did not end. Important lessons were learned. You may have even grown wiser and stronger because of the setback.

Reflecting on your past in this way will go a long way to challenging the idea that you must succeed at some endeavor within in short period of time. It may also convince you that your greatest strengths were built during times of struggle, rather than periods of success. Life is filled with both of these elements.  

Two: “I deserve…”  Then fill in the rest of the sentence. It may be “I deserve to have that job” or “I deserve to have that nicer car” or I deserve to have that person’s affection.”  This thought is often followed by “If I don’t obtain it, then life is not fair.”

When we feel as though that which we deserve has been kept outside our reach, resentment is likely to grow.

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And why wouldn’t it? If we deserve to have something, then naturally we are inclined to expect that we will eventually possess that thing/status/object that we deserve. But what happens when it remains outside our reach? Resentment takes root.

As Anne Lamott has written, “Expectations are resentments waiting to happen.”  

Resentment does not make a merry companion on the road of life.  

That does not mean it is wrong to have goals – far from it. Goals are important. That much is obvious to each of us. It is the unwarranted sense that we deserve to prize of winning a particular goal that should be guarded against.

Solution: Take a deep breath, focus on savoring the present: it is part of the journey, of ‘paying your dues.’ The current effort and toil will become part of your life story, and will make later success all the sweeter. Look around at what others have had to do to win in their careers and personal life. Get some perspective. Reaching big goals requires hard work. Setbacks along the way are inevitable.

After coming to terms with that truth, take the next step. Life does not revolve around any one of us. Be humble. Humility keeps one grounded, and provides much needed perspective. Part of this perspective includes accepting that many of the things we desire, are not necessarily things we deserve.

Three: “I’m not sure why, but deep inside I know that I’m lacking. In some way, I am just not enough. But I’m uncertain what is missing, so I’ll look around, maybe check out Instagram and Facebook to see what others have which make them so happy. Then I’ll know what’s missing within myself.”

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Solution: My advice for someone who struggles with this distortion (closely related to the “Imposter Syndrome”) is to stop with the comparisons. Stay away from Facebook (go cold turkey, start a Facebook Anonymous group, whatever it takes, but stop comparing your life to that of others). Do a ‘cleansing fast’ of Instagram. Take a break, a very long break, from social media. 

Now that you have more time in your life, devote it to building deep, genuine relationships with a small number of friends and family. They will value you for who you are, warts and all. These relationships should convince you that, like all of humanity, you really are lacking, and paradoxically you really are still ‘enough.’  Good enough to be loved, good enough to be valued, and good enough to bring joy into the lives of others.

Conclusion

To live life to the fullest we must overcome those obstacles that hold us back. Some of these obstacles include the thoughts we embrace. Thoughts we unthinkingly assume to be true.

Once we begin to notice these thoughts, and challenge them, new paths for pursuing a full and rewarding life begin to open up. This takes a little work, but the rewards make the effort well worthwhile.

Take a moment to see if any of the barriers to happiness listed above might apply to you. Don’t spend another day struggling with unrealistic expectations that hold you back. Push them aside, and see how much happier life can be.

 

 

11 Tips For Parents: Teen Proofing Your Child.

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How To Avoid Massive Teenage Drama, Save Your Sanity, and Stay Close To Your Teen

The mother sitting in front of me was in tears. She looked thoroughly defeated, but more than that, she was worried. Her husband, sitting next to her, sighed deeply and shook his head in anger. “We’ve been through this a million times. It’s like hitting your head against granite… and I’m just about done.”

Sitting across from them was their 16-year-old daughter Rachel. Her expression was one of contempt mixed with boredom. She sat slouched in an overstuffed office chair, arms folded across her chest, a thousand mile stare directed out the window.

Before entering high school Rachel had been an easygoing youngster who seemed to bounce through each day as though she hadn’t a care in the world. Her parents described her as having been “a bright, happy, and outgoing” girl.

Sometime in the middle of her freshman year, however, they noticed a change in their daughter. Their easygoing daughter began to sulk when asked to do chores, and the little arguments around inconsequential topics became more frequent. Shortly after this the school began to call letting the parents know that Rachel had skipped a class, or had been found leaving the high school campus with a group of other teens.

Around this same time Rachel’s mood became even more irritable. She withdrew frequently, spending hours behind a closed bedroom door. Getting her to talk at the dinner table had never been an issue in the past. Now the parents felt lucky if their daughter spoke up at all.

As the semester wore on it became clear that what their daughter wanted most was to be left alone - unless she needed to be driven somewhere, in which case the agreeable and sweet side of Rachel from times gone by suddenly reappeared.

The parents responded to these changes by telling their daughter how disappointed they were in her choices. When this did not have the desired impact they would shift to stern reprimands and punishment. Confrontation and tense exchanges started to punctuate each week.

Rachel’s behavior always showed brief improvement after one of these heated conflicts, but over time she learned to simply agree with whatever her parents said, and then immediately ignored all of their warnings.

Her mother and father unwittingly developed a routine. Each evening before going to bed the conversation would turn to the topic of Rachel’s most recent act of defiance. Back and forth they tossed ideas, expressed their worry, spoke of their anger and wondered what had gone so wrong. The home that two years before had been filled with laughter and a sense of intimacy was now an emotional war zone.

Anger and conflict had replaced the warmth and sense of oneness they had previously enjoyed. Rachel’s parents were confused. How could such a sweet girl transform into one who was so resentful and rebellious? How could their family life so quickly shift from being a haven of support to a crucible of conflict?

The ‘last straw’ occurred when the parents returned home early from a ‘date night’ and found that Rachel had invited a boy into the house for a date night of her own. Feeling desperate, the parents decided to call a therapist.

How To Save Your Teen (and yourself) From The Pain of Adolescence

The story of Rachel is a familiar one: a rebellious adolescent whose misbehavior creates years of emotional turmoil within a family. There are, however, ways of making this outcome less likely. Of putting the odds for a happy adolescence in your favor.

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Preparation is the key. From the time a child is a toddler, parents need to focus on preparing their child to meet the challenges of adolescence. 

To know how to prepare your child for adolescence you need to recognize what challenges your teen will face. Only by knowing what lies ahead can you also know how to prepare your child.

This is no different from any other aspect of life. If you are preparing to run in a marathon, your training will focus on endurance running. On the other hand, if you are preparing to compete in a chess tournament your training will involve studying common chessboard strategy, and improving your ability to think three or four moves ahead in the game. Running several miles each day in order to prepare for a chess match…. Well, not too helpful.

So what challenges do teens face? To get a clear answer to this question we need to realize that this period of time is the “launch pad” to adulthood. The youngster who recently enjoyed playing with Legos or dolls, is now immersed in the business of preparing for adulthood.

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The teen’s job during these years is to:

Begin to make independent decisions

Select life goals

Grow more responsible

Find a path in life that fits with his/her abilities and interests

Develop mature and supportive relationships with peers

Learn how to understand and relate to the opposite sex

Figure out how to maintain a close relationship with parents while still becoming increasingly independent.

Deal appropriately to the rapid physical transformation of their body   

There is no other time in an individual’s life where so many changes are required of an individual in such a short period of time. In case things are not already dicey enough, added to all of this are the following:

A massively heightened sense of insecurity (found in most teens)

A belief that the world revolves around oneself

A growing desire to distance oneself from parental influence

An influx of hormones.

This begins to sound like a cocktail designed to drive both teens and parents to the limits of crazyland.

The good news. It doesn’t have to go down that road!

What Teens Need To Successfully Navigate The Adolescent Years

To travel through adolescence and succeed, to traverse these years and remain close to parents and experience minimal drama, a few basic skills must be firmly developed ahead of time. These skills, or aptitudes, include the ability to avoid falling into the following traps:

Giving in to peer pressure in order to be “cool” or popular

Acting on emotion rather than reason

Lack of focus – chasing the newest ‘shining object’

Feelings of profound inadequacy (which may lead to a poor choice friends,         drug/alcohol abuse, self-harm)

Failure to consider the advice of trusted adults

Combative attitude toward parents

When the skills needed to avoid these pitfalls are taught from an early age, they are more likely to become deeply rooted in a child’s character. They become second nature.

This makes it easier to resist the pressures mentioned above that every teen faces.

How To Prepare For Adolescents

What can you do to help your child be ready for the challenges that lie ahead? Several things. Some easy, some not so much. But none of them requiring superhuman skills. Here is a brief list. 

Let your child fail. Yes, I know, you’ve heard it before – but let it sink in. All of us parents know we need to do this, and all of us hate letting our children fail.

Even so, we know deep down that setbacks in life are inevitable. They are something each of us face from time to time. Learning to experience failure, and have it neither define nor defeat you, is how one grows stronger. It is an essential skill for living a successful life.

Be supportive but not enabling. When your child has fallen short in some way, it is helpful to provide support and perspective. When life has dealt them a cruel hand in some way be the shoulder they can lean on, but don’t treat them as a victim. Do this by reflecting confidence in their ability to bounce back, to overcome. Help them realize that they may be victimized by fate, or mistreated by friends they had trusted, but help them never lose sight that they are capable of overcoming those heartaches. Those that overcome hardships are victors, not victims.

Show your child that you have confidence in him/her.   Confidence is learned. Children learn confidence by seeing it reflected in their parents’ appraisal. (That is one of the reasons for letting children try and fail – it reflect confidence in the child’s ability to persist and win the goal with continued effort). Confidence is also learned through experience. Steer your child toward activities within which he or she can excel.

Put setbacks in perspective, they are not the end of the world. When comforting your child in response to some setback in life, provide some perspective. This is not to say you should minimize the distress your child feels, but the events surrounding that hurt need to be realistically viewed.

Place more emphasis on character than accomplishments (the effort put into getting an A or B grade is much more important than the grade itself). Character trumps ability. Without character ability is hallow, it is like a ship without a rudder. Your child’s persistence and effort is more important than the final outcome. The youngster who is naturally gifted and earns straight A’s putting forth little effort is much less ready for adulthood than the child who earns straight B’s by putting forth consistent effort.

Build a relationship that welcomes your child’s ideas, even when those ideas conflict with your own. Speak with interest and genuine regard about your child’s ideas, even if they appear foolish. You need not pretend that they are accurate. You should, however, try your best to help your child understand that you welcome the opportunity to understand his or her perspective. In this way, when your youngster is a teen, he or she is likely to feel more comfortable openly discussing various topics with you.

Teach your child how to choose friends wisely.  When children are young parents do best by helping them to choose their friends. These relationships will teach your child what to expect from peers as they grow older. They will also help to shape your child’s preference for the type of friendships formed later in life. When they are in their teens, these foundational friendships will act as guardrails to keep them on track. Badly chosen friendships will act as seductive invitations to behave in ways that have long term consequences.

Teach your child that it is better to follow his/her judgement/moral compass than it is to win the approval of others.  Celebrate every instance of your child following his/her conscience. When faced with the enormous peer pressures of the adolescent crowd, conscience will be the ultimate bulwark against regrettable decisions.

Teach self-control.  Performing household chores, not allowing temper tantrums in older children, developing good manners, sticking to routines even when it is difficult are all ways in which children learn self-control. When confronted with the mix of adolescent stress and hormones, self-control is a stalwart friend.

Emphasize respect for authority even while emphasizing independent thinking skills.  Children who respect authority figures develop a stronger sense of confidence than those who constantly rebel. They have fewer problems at home and in school. Life is sweeter.

Nevertheless, there needs to be a balance. Your child needs to learn to think independently. To understand that authority figures can be respected, and still be mistaken. This is a process. A gradual process.

By helping your child acquire this perspective, the teen years will be relatively free from the unnecessary travails that arise when an adolescent feels obliged to rebel against authority figures.

Teach your child to be grateful.  Gratitude provides perspective, instills a sense of connectedness to others (those to whom we are grateful), and encourages generosity. Children who learn gratitude are happier, and this acts as a barrier to the discontent that afflicts many teens.           

Conclusion

The teen years can be a wonderful time of growth, or a tumultuous period of stress for the adolescent and his/her family. To make the most of these years requires preparation. Specific skills need to be developed that prepare the teen to meet the challenges that will inevitably be faced. Parents who, early on, begin to develop these skills in their children are much more likely to have teens that emerge from adolescence ready to take their place within the world of adults.

You can do this…. Start now.

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Lessons Learned From The Other Side Of The Couch

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Facing Heartache & Pursuing Happiness

I’ve been a therapist for many years now. Over the course of those years people of various backgrounds, struggling with a variety of different challenges, have sat across from me.

Some have been young, others old. Some were full-time homemakers, others were skilled tradesmen, students, or unemployed. Still others were involved in successful practices involving medicine, the law, or business.

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A number of these individuals had grown up in wonderfully supportive homes, while others had struggled growing up in abusive, chaotic and horribly dysfunctional families.

Pretty early on in my career I began to notice that regardless of one’s history, or present circumstances, the people who succeeded in building a happy and full life had certain traits in common. For some people, these traits, or characteristics, seem to have developed easily. Perhaps they were winners in the genetic lottery. For most, however, the traits that helped them weather life’s storms, and create happier lives, appeared to be hard won.

Today I want to look at just one of these traits. Of all the qualities that add to one’s ability to build a full and happy life, this one may be the most difficult to build. But not impossible. Far from it. With persistence, and continued practice, this trait will take root in one’s character, and a richer life will be crafted as a result.

Responsibility   

Assuming responsibility for one’s happiness is one of the top key traits I’ve seen in those who appear most fulfilled in life. This is true whether the person is currently struggling with grief, depression, anxiety or some other distress. It is not that these people don’t recognize the severity of the hardships that bear down on them: they do not view life through rose colored glasses. Very much the opposite. They are realists to the core.

Instead of glossing over the heartaches of life, they squarely acknowledge the pain of each setback. Having down so, however, they also take full responsibility for the task of then moving forward and building a happy life as best as their abilities will allow.

A more natural reaction to have in the face of great heartache, and one that many of us may have indulged in on occasion, is to exclaim “If only XYZ were different, then I could be happy.”

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This way of thinking is attractive because it often contains at least a kernel of truth. If your boss had been fair, you really would have received that promotion, and that truly would have made life much better. If that other driver had not run the red light you would not have been injured, and would not now be facing months of physical therapy. If only….

It’s interesting to note, however, that those who manage to build happy lives despite these sort of hardships do not spend a lot of time dwelling on the “If only” scenarios of life. Sure, they recognize when life has dealt them a harsh challenge. They might momentarily become sad, grief stricken or angry. But this is does not become an entrenched state of mind. They find no permanent comfort in viewing life from that perspective. It is not a mental state where they set up camp.

More often than not, when they do get dragged into those mental marsh lands, they find ways to dig themselves out. They continue to look for paths to higher ground where they can stand on the firmer road of hope, friendship, and a life of shared purpose.  

What fuels these men and women, in part, is a sober acceptance of the reality that only one person can ultimately change their life. Only one person has responsibility for their happiness. That one person, of course, is them self.

An example of this approach to life may help drive the point home. Some years ago I had been talking to a friend, Chris, at dinner when the conversation turned to the topic of his father. Chris mentioned that his dad (let’s call him Jack) had a difficult childhood. As a teen growing up in the Midwest in the 1950s, Jack unexpectedly found himself in a compromising situation. Sizing he situation up, he quickly decided that leaving the state in search of friendly environs would redound to his great advantage. Jack had heard that California was the land of opportunity, and so a young man in his teens he struck out on his own and headed off to the Golden State.

After arriving in California he bounced around from job to job, even spending some time as a professional boxer. Eventually, however, he decided that learning a trade was the way to carve out a more secure financial future. Jack figured that becoming an electrician would be a good idea: it provided a decent income, and work would always be plentiful for someone with that skill set.

Getting an electrician license required several years of apprenticeship. The rewards of being in that trade would not come easily. Even so, Jack knew that the payoff would be worth the price and apprenticed himself to a local electrician.

After several years of working long hours for very little money, Jack went to the government office that issued electrician licenses. After patiently waiting in line, he stepped up to the licensure desk where a neatly dressed woman sat. “Good morning mam. I’m here to apply for my electrician’s license.”

The woman looked puzzled and remained quiet for a moment before saying “You can’t get an electricians license.” Jack thought she had misunderstood. “I’ve got all my documents right here. All the hours I’ve apprenticed. It’s all in order.” He politely placed his paperwork on the desk.

Without looking down at the documents the women calmly replied “It’s not a matter of how many hours you’ve apprenticed. That’s not it at all. We don’t issue electrician licenses to negroes.”

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Chris finished telling the story.  I thought for a moment, then commented about how the injustice of the situation would cause me to be both angry and bitter.

It seemed a reasonable sentiment. After all, without any just cause his father had wasted several years of his life, hours of labor, and the application of his skills pursuing a goal that was foreclosed by blatant bigotry. I started to elaborate but my protests were cut short. Chris leaned back in his chair and began laughing.

Smiling and shaking his head in disbelief he said “Well, you don’t know my father. He is one of the least bitter men I’ve ever known. Nope, if he was bitter he didn’t let it stick to him. Instead he just walked away and began to think about other trades he could pursue. Didn’t take him long to land on the idea of selling real estate… and he ended up doing extremely well. I mean really, really well. My dad wasn’t one to let others determine his happiness. He took charge of his own life.”

That story struck a note. Chris’ father had not justified the bigotry that foreclosed the possibility of being an electrician. But neither did he let it define him, consume his thoughts, curtail his pursuit of success, or dampen his happiness. He focused on what he could do to carve out a life that was meaningful, full, and satisfying. As a result, he was not only freed from bitter resentment, but emotionally unburdened so as to fully enjoy the success that his continued hard work and skills would eventually bring about.

Conclusion

Whether we are struggling with gross injustice, misfortune, illness, or the ramifications of our own poor choices, the final responsibility for a life well lived ultimately rests on our own shoulders.

It’s true that some of us face much tougher challenges than others. The disparity in the hardships we face can seem unfair. Even so, this does not alter the reality of how we secure a full and happy life: by accepting that no matter the challenges we face, it is up to each of us to build a full and happy life.

 Folsom therapy

Those that I’ve known who do this well would not claim that it is easy. Many of them have been faced with terrible losses and setbacks. Their lives marked, at times, by great heartache. But even so they push on, not letting themselves remain focused on the pain, but relentlessly searching for ways to drink in whatever joy they can find in life.

This does not erase the sorrows that invariably must be faced. But for those who adopt this approach, it affords a road that more often than not leads to a much brighter future.

How To Get A Good Night's Sleep

Say Goodbye To Insomnia

 Sleep crescent moon over city

Have you ever lay awake at night, exhausted, tired, and ready for sleep but found that your body would not cooperate? You were ready to saw some logs but your brain stubbornly refused to switch into ‘sleep mode?’

If so, you are not alone. Sixty million Americans struggle with insomnia at some time throughout any given year. For many it is a chronic problem with a huge impact. A lack of sleep can ruin your attention span, make emotions swing like the lead singer in Rumba band, ruin attempts to stay with a healthy diet, torpedo efforts to exercise and just generally make you feel as though you are one of the cast of the Walking Dead.

Chronic Health Conditions Related to Lack of Sleep

A lack of sleep is not just inconvenient, or frustrating, but also is associated with an increased risk of significant health problems.

Research shows that those who sleep less than seven hours a night are more likely to develop coronary heart disease, experience a heart attack or stroke, have arthritis, chronic obstructive pulmonary disease, asthma and diabetes.

In addition to these health concerns, diminished sleep has a huge impact on one’s performance. As you can see from the graph below, performance is greatly diminished over the course of just a few days when one is unable to get enough sleep.

 Chart of decreased performance with increasing lack of sleep.

This graph shows the number of mistakes people made, on average, when faced with a simple task over the course of seven days. Some individuals were allowed to sleep 9 hours a day, other 7 hours, still others 5 and 3 hours respectively.

By the end of the week those people who had gotten by on 3 hours of sleep each night made 18 times more mistakes than those who had been getting 9 hours of sleep. Even those who had slept 5 hours a night ended up, by week’s end, making 6 times more mistakes than the group who had slept 9 hours per night. The 5 hours/night group also made nearly twice as many mistakes as the 7 hours/night group.

What might the trend look like if it were extended beyond one week? Perhaps for a month, two months, or a year? Such long periods of poor sleep are not unusual for someone suffering with insomnia.

What Causes Insomnia?

There are multiple reasons why people develop insomnia. Some of these are physical, (e.g., hormonal changes), others are psychological (e.g., stress/anxiety), and still others are environmental (e.g., sleeping next to someone who snores).

Medical News Today provides a nice summary.

“Insomnia is commonly caused by:

Disruptions in circadian rhythm - jet lag, job shift changes, high altitudes, environmental noise, extreme heat or cold.

Psychological issues - bipolar disorder, depression, anxiety disorders, or psychotic disorders.

Medical conditions - chronic pain, chronic fatigue syndrome, congestive heart failure, angina, acid-reflux disease (GERD), chronic obstructive pulmonary disease, asthma, sleep apnea, Parkinson's and Alzheimer's diseases, hyperthyroidism, arthritis, brain lesions, tumors, stroke.

Hormones - estrogen, hormone shifts during menstruation.

Other factors - sleeping next to a snoring partner, parasites, genetic conditions, overactive mind, pregnancy.”

WHAT CAN YOU DO TO FLIP THE SLEEP SWITCH TO “ON”?

If you struggle with getting to sleep, it is important to know that there are many ways to cure this problem. Prescription medication is one of the most common solutions. The major shortcoming of taking this route to getting some sleep is that medications usually offer only a short-term fix. When you stop taking the medication, insomnia frequently returns. Solutions that do offer longer lasting restful sleep, and don’t include the potential side effects of medication, are what most people prefer.

In the sections below, I will discuss some of the most common, and useful, non-medication approaches for solving your insomnia. We can start with a summary (below) and then work through each part in more detail.

 Insomnia Ways to solve insomnia

TIP #1: ESTABLISH A HEALTHY SLEEP ROUTINE

Make sure you have a good “pre-sleep” routine. This is similar to the “pre-game” routine that some athletes use. With regard to getting some ZZZZs, however, a pre-sleep routine is referred to simply as having good “sleep hygiene.”

The benefit of having a standard routine that you go through each night before bedtime is that you begin to train yourself to sleep. Routines build habits, so the idea is to have a routine that leads to the habit of falling asleep. This usually includes:

·        Going to bed at the same time each night

·        Turning off the television and internet an hour before sleep

·        Taking a shower or bath

·        Avoiding arguments or working on things that are stressful

·        No caffeine

·        Performing some light stretches or meditation

·        Taking a few quiet moments to consider what went well in the day

·        Writing one or two things down for which you are grateful

·        Listening to calming music

·        Saying one’s prayers

·        Meditating

 Woman working on computer in bed

Do you see a pattern in the above suggestions? It includes avoiding stimulation (e.g., television, internet, caffeine, arguments, etc.), and focusing on what is calming and relaxing (e.g., what went well in the day, taking a shower, calming music, prayer, etc.).

When you do go to bed make the room as quiet as possible, and as dark as possible. Even the light of a digital clock has been shown to disturb the sleep of many people. Once your head is on the pillow take a deep breath and slowly exhale.

Repeat this several times while imagining a peaceful scene (the end of the day is NOT the time to review the day, or solve problems that await you in the morning).

It takes some practice to develop this sort of routine but with a little time and effort it works very well for many people.

TIP #2:  Consider using supplements.

There are many supplements that may help you get a better night’s sleep. If you would like to explore a variety of these potential aids for sleep, you can look at reviews by Consumer Labs, and another review by Psychology Today.

For our purposes, however, I will just mention one of the most popular supplements, melatonin (available over the counter at pharmacies and health food stores).

Melatonin is a naturally occurring hormone that your body uses to regulate cycles of sleep and wakefulness. In the evening, your brain’s production of melatonin rises. This helps in preparing you to go to sleep.

Common sense suggests that if you can increase your melatonin production in the evening you will be better prepared to sleep. But this is difficult to do. It’s not as though you can tell you brain “Please ramp up the melatonin production now because I would like to be snoozing in an hour.”

So, how can you increase the melatonin in your system on demand?  Supplements.

The melatonin that you take as a supplement is a synthetic form of the hormone your body produces. Early research on melatonin and sleep was very promising, but later research has been more mixed. Put somewhat differently, “Your mileage may vary.”

I’ve known people for whom melatonin is a huge help, and others for whom it appears to have little impact.

The good news is that melatonin appears to be safe, and it is not expensive. So if you want to try it, the current research suggests there is little to lose (OK, maybe five dollars).

Let me be clear, I'm not a physician and I'm not recommending that you use melatonin. Do a little research, consult your doctor, and decide if this is something you would like to try. (If you are interested in prescription drugs used to treat insomnia the Harvard Medical School News Letter is a good start). 

TIP #3:   Get out of bed!

Well that’s an odd way to fall asleep you say to yourself. Yes, but an odd way that works for most people. Here are the details of how to make it work.

If you get into bed, and after twenty minutes are still awake, then it’s time to get up and leave the room. Why? Because you want your brain to associate bed with sleep, not with being awake (again, we are looking to develop habits for your brain).

Once you are out of bed, go to another room and find a book. The most boring book you can find. If you don’t have boring books borrow one from your neighbor, or better yet buy one. Sit down in a comfortable chair and begin to read. Soon you’ll feel sleepy.

Keep reading (by the way, if for some reason you become interested in the boring book put it down and grab a book that is twice as boring).

Within a short while you will become even sleepier. At that point you head back to bed, repeat the deep breathing routine once more, think of a relaxing scene and fall asleep.

But what, you ask, should I do if I still cannot fall asleep? Cursing the fates that have resulted in your being awake would be a good start. Not too loudly though – there are probably others in the home who are sleeping.

I should add this if you are married it would be a very bad idea to wake your soulmate. There is a great deal in life that you want to share with your spouse, but insomnia is not one of those things.

OK, so what to do this second time when repeating the ‘get out of bed’ routine? Sadly, you do exactly what you did the first time. Find a comfy chair and a boring book. Read until you are sleepy. How sleepy? To the point where you feel that you might doze off any minute.

How many times should you repeat this routine in a given night? As many times as it takes to get to sleep.

Yes, it can be very tough the first night or two, but eventually you will sleep (see the CAUTION below about not napping later in the day).

Once you have repeated this routine to the point that you are finally asleep, a milestone will have been reached. That is you will have successfully taken a major step toward teaching your brain to shut down when your head hits the pillow.

If that takes a few nights of getting out of bed, well, that's not too bad compared to spending months, or years, wrestling with insomnia.

The bottom line is this: most people who follow the advice I’ve given will find that they can eventually fall asleep at their normal bedtime. Sometimes it takes several tries before success is reached, but don’t give up, it will happen.

One caution. Don’t take naps while you are trying to get your sleep back to normal. Only after your sleep has returned to a healthy pattern should you go back to taking a nap. Even then, try not to nap late in the afternoon.

Also, even if you have had a sleepless night hopping in and out of bed like a jazzercise instructor on steroids, don't change your bedtime to a later hour in the evening. You are likely to find that this results in the same problem occurring, but just later in the night.

Remember, we are looking to establish habits and routines! That's what trains the brain. 

There are other ways to tame your sleep, but for most people the three approaches just described will do wonders.  

TIP #4: DO SEVERAL, OR ALL, OF THE FOLLOWING

Don’t exercise in the two to three hours before sleeping

No caffeine in the evening. When to cut out caffeine will vary from person to person. You will need to experiment. For some it means no caffeine after 4:00 PM. For others the cutoff time might be two hours before bedtime.

Reduce fluid intake several hours prior to bedtime – drinking too much of anything just prior to bedtime will lead to less sound sleep even if it does not lead you to get up in the middle of the night.

A snack prior to bedtime is fine, but not a heavy meal. Let your body focus on sleep rather than digestion.

Make sure you have had 20 minutes or more of exposure to sunlight in the day: sunlight is important for regulating your sleep cycle (your brain knows when you’ve skimped on getting some rays)

Darken the room that you are sleeping in – close the blinds, close the door, and turn off all the lights. Even the light from a digital clock will cause sleep disturbances in some people.

Experiment with room temperature: the ideal temperature for sleep varies with the individual (Artic cold for me, thanks), and this one change can make a huge difference.

Stop being cheap. You know who you are. Buy a good pillow, and while you are at it make sure you have sheets that are comfortable (you don’t need to buy the most expensive linens, but if you crawl into bed and it feels like you are a monk wearing an itchy hair shirt, it’s time to upgrade your linens). I’m sure I don’t have to talk about the need for a good mattress.

Do not overdo alcohol – a glass of wine/beer is fine, but more than that will disrupt REM sleep, which is the most important stage of sleep in allowing you to feel fresh and ready for the next day.

No naps after 3:00 PM

Take a warm shower or bath before bed

Relax prior to going to bed. More specifically, let your brain relax. That means it is not a good idea to go to bed right after watching a movie, or working on the computer. Yes, some of you can manage that transition with ease. But if you are struggling to get a good night’s rest, try something different. Create a routine where all electronics are off, the house is quiet, and you have a chance to listen to relaxing music, read a book, or engage in conversation.

WHEN TO SEE YOUR DOCTOR

You may have tried several of the ideas discussed above and still cannot get the sleep you need. Perhaps you are wondering if it is time to make an appointment to discuss your sleep problem with your doctor. WebMD has the following guidelines to consider when making this choice. 

  * Fall asleep while driving?

  • Struggle to stay awake when inactive, such as when watching television or reading?

  • Have difficulty paying attention or concentrating at work, school, or home?

  • Have performance problems at work or school?

  • Often get told by others that you look tired?

  • Have difficulty with your memory?

  • Have slowed responses?

  • Have difficulty controlling your emotions?

  • Feel the need to take naps almost every day?

Because the list above is not a quiz that provides a score, you will need to use your judgment in considering whether the number of symptoms that apply to you reach the threshold for making a doctor’s appointment.

COGNITIVE BEHAVIORAL THERAPY

It is worth mentioning that when all else fails, research shows that Cognitive Behavioral Therapy (CBT) is the most effective way to provide long lasting relief from insomnia. I won’t go into how insomnia is treated with CBT (perhaps in another post), but for those of you who continue to struggle with consistently getting a good night’s rest, CBT offers another way to tackle this problem.

BOOKS YOU MIGHT ENJOY

If you diligently apply yourself to using the strategies discussed above, there is a good chance your sleep problems will diminish, and possibly be resolved altogether. But in case you want dig a little deeper into this subject, there are a couple of books you will find of interest: Why We Sleep (Matthew Walker), and The Sleep Book: How To Sleep Well Every Night (Guy Meadows).

CONCLUSION

Life is too short to be saddled with insomnia. It robs you of energy, diminishes your focus, creates irritation, lowers performance, and increases the possibility of developing a serious health issue. If you are like millions of others who have a difficult time getting a good night’s sleep, try some of the strategies we’ve just looked at, and see if that doesn’t get you started toward a better night’s sleep.

ESSENTIAL & SHORT GUIDE TO DEPRESSION

 DEPRESSION ANXIETY TRAUMA PTSD

How To Tell If You Have Serious Depression

And What You Can Do About It

Depression is a term that most people are familiar with because it is frequently used to describe one's mood. You no doubt have often heard someone who is facing a challenging time in life say “I guess right now I'm just feeling a little depressed about all of this” or something to that effect. Or, you may have heard others comment “Oh, now that's really depressing.”

What these comments point to are not the sort of depression we will be considering. What those statements (and similar statements) refer to are momentary periods of time when a person is rather sad, disappointed, or melancholy.

When therapists refer to someone as depressed they have something much more severe and more specific in mind. Indeed, therapists try to be very specific regarding depression and therefore divide this concept into various subtypes such as major depressive disorder, dysthymia, cyclothymia, etc. 

I also want you to keep in mind that depressive symptoms may occur in conjunction with other disorders. For example, one may have a psychotic disorder with depressive features, an Adjustment Disorder with depressive features, and so forth. People who suffer with anxiety will also often have symptoms of depression. This is due to the stress and sense of isolation that frequently accompanies severe anxiety.

You can see that depressive symptoms are depressingly common across many disorders.

Depression shows up in many different ways, and some of these are not easily identifiable, while others are more obvious.  For some folk depression comes on suddenly (over a matter of days or a few weeks). For others it develops more slowly over the course of several months (this slowly developing depression may make it more difficult for the person who is experiencing it to realize that he, or she, is depressed). 

The main feature of depression, not surprisingly, is a depressed mood. Not just a little sad or blue, but truly depressed. The world begins to appear rather grim, the day to day present moments lack joy, and the future holds less appeal than it once did. In addition, those who have severe depression typically experience “anhedonia”, which is a fancy way of saying that there is a lack of interest in events/people/hobbies that, previous to the current time, had given the  child, teen or adult a good deal of enjoyment.

Related to this symptom is another, a tendency to become more socially withdrawn. The problem here is that when someone withdraws from family and friends they end up feeling more isolated and uncared for – leading to greater depression.

Quite frequently depressed individuals have difficulty concentrating, sometimes to the point that their school or job performance is compromised.

A lack of self-esteem is frequently seen in those who are depressed, and this is most often thought to be a result of all the other symptoms that haunt the depressed individual.

There is another class of symptoms that need to be looked at and these are called vegetative (related to functions essential for life). The list is rather short.

1.   Lack of energy being common among those suffering from a severe depression.            This will most often be seen in general fatigue.

2.   Changes in appetite are common (both increased appetite as well as a lack of                appetite... it varies from individual to individual). These changes are generally                accompanied by changes in weight.

3.   Disturbed sleep is frequently seen and may appear as insomnia, restless sleep, or          a need for longer periods of sleep.

4.   A diminished sex drive is also common.

5.   Frequent crying is not uncommon (with or without a reason).

6.   Thoughts of suicide or self-harm sometimes arise (but not all people with a severe          depression experience these thoughts).

COURSE OF DEPRESSION

Depression is one of the most prevalent mental disorders found among adults. About 6% of the population struggles with depressive symptoms. It is somewhat more common with women (8%) than with men (5%). Depression also is a major problem impacting children and teens.

Those who suffer from depression are also likely to suffer from anxiety (approximately two thirds of those who are depressed also have anxiety).

People who have experienced childhood trauma are more likely than others to have depression and anxiety. Moreover, when depression occurs with anxiety it is likely to last longer than when it occurs without anxiety. 

Although the course of depression varies according to the individual, research suggests that 70% of depressed adults recover within a year of the onset of symptoms.  Of those who are still depressed at the end of the first year, many (approximately 12%) will remain depressed for up to another five years.

Early intervention is crucial, although it should also be stressed that it is never too late to make significant changes that result in the resolution of depression.

Depression may develop gradually or quickly. At times it can be traced to specific events in an individual's life such as the loss of a loved one, or a series of significant misfortunes (e.g., divorce followed by the loss of a job followed by a major move that puts trusted family and friends on the other side of the world). Conversely, it may develop gradually, with no specific event being easily identifiable, but instead a steady decline in the individual's mood and reduction in healthy ways of thinking and behaving which in turn accelerate the depressive decline.

KEY SYMPTOM CHECKLIST FOR DEPRESSION

Depressed mood

Anhedonia (lack of interest in events/people/hobbies)

Lack of energy

Changes in appetite

Low self-esteem

Disturbed sleep

Diminished focus/concentration

Social withdrawal

 DEPRESSION ANXIETY TRAUMA PTSD

HOW TO BEAT DEPRESSION: THE ROAD BACK TO A HAPPIER, FULLER LIFE

There is good news. Depression can be resolved. Although when you are depressed it may feel hopeless, the truth is that most people do not stay depressed. That by itself tells us that logically, there is every reason to expect that depression will be beaten, and a happier life regained.

There are many ways to fight back against depression. Some of these strategies are specific to what has caused the depression. Other strategies are not related to the exact reasons the depression took hold, but they are nevertheless effective. I’ll briefly mention several of the general strategies.

Take the Positive Psychology Approach          

Positive Psychology is a field that focuses on maximizing psychological health and happiness through positive thinking and behavior. Sound simplistic? It is. Also, effective.

Gratitude     Using this approach you could try focusing on gratitude (shameless plug alert, you can get a pdf guide on research-based gratitude exercises by signing up for my newsletter at forresttalley.com).

If you take this approach you might try keeping a daily gratitude journal, or writing a single one-line gratitude note to someone each day.

Help Others     Research, and common sense, also show that focusing your energies on helping others who are in need helps to lift depression. We’re not talking the “rushing into a burning building” type of help. Even giving someone a ride to the doctor’s office, or mowing the neighbor’s yard, will boost one’s mood.

Exercise     Brief moderate daily exercise is a tried and true mood booster as well. No need to go wild, just 15 to 20 minutes a day of walking is likely to make a difference in depression when done regularly over time.

Behave The Way You Want To Feel     Act as though you were happy. Actions have powerful consequences. Actions send signals to the brain that in turn responds by releasing certain neurotransmitters that change our mood.

For example, research has found that when you have people smile, even when they do not know that you are intentionally having them smile, their mood improves. In one study researchers compared people who held a pencil in their mouth in a way that imitated a smile to those who also were instructed to hold a pencil in their mouth, but in a way that inhibited smiling.

All subjects then performed an identical task and given a questionnaire to report on their mood (among other things). The unwitting smilers were much happier than non-smilers.

There are numerous other studies showing the powerful link between behavior and mood/attitude (interesting fact, did you know that even simple changes in your posture can influence your confidence?).

The bottom line is, when depressed it is helpful to act happy. You don’t need to be the life of the party or pretend that things have never been better. But you will do yourself a favor by smiling, pulling your shoulders back, greeting others warmly, and engaging with family and friends.

When we give in to feelings of depression, looking glum and keeping away from others, we make things worse. I would not want to do that and I’m certain you would not want to either.

Before moving on, however, I want to be clear. It’s fine, in fact it’s a good idea when you are depressed to confide these feelings to your inner circle of friends/family. Everyone needs support, make sure you find it among those with whom you are closest. But having done so, dust yourself off, and continue on with the business of life. By taking this approach you will be training your brain to resist depression.

Three Good Things     The last thing I’ll mention regarding positive psychology is that it can be helpful to end each day by writing down “Three Good Things” that happened, what part you had in making them happen, and how you can use those insights to make the next day a little better. Do this for two weeks and see if your mood has not improved.

Psychotherapy

There is a mountain of research showing that psychotherapy is an effective approach for dealing with depression. The real question is what type of psychotherapy is most effective? This has been debated for years and continues to be debated.

The data suggest that there is no one approach that is clearly the winner. What matters most is that the therapist and client are a good fit (the client likes the therapist, believes he/she is competent, understanding, respectful, trustworthy, and has a reasonable plan for dealing with the depression).

What this means for someone who is depressed and seeking psychotherapy is that finding the right therapist is more important than finding the right type of therapy (see blogs dated July 17th and 24th 2018).

But let’s be clear, the right therapist is at least somewhat related to the sort of therapy he or she practices. If you hate the idea of hypnosis, then you will not feel as though a hypnotherapist is a good fit for you, no matter how competent, understanding and trustworthy that person may be.

In all likelihood a therapist will primarily practice one of the following three types of therapy.  Cognitive Behavior Therapy, Interpersonal/Psychodynamic Therapy, or Eclectic Therapy.

Cognitive Behavioral Therapy (CBT) focuses on finding the links between one’s thoughts, behaviors and emotions. After discovering these links the therapist makes recommendations on how a client can change his or her thoughts and behaviors in order to bring about a change in emotions (in this case, depression).

An interpersonal/psychodynamic therapist will help a client discover these same links, but also tries to put that information within the context of the client’s history. The past is considered an important force in molding the client’s current patterns of thoughts/behavior/feelings.

By uncovering how it has impacted a client (that is, making clear the connection of the present with the impact of the past), the client is better able to free him/herself from its powerful influence. Being aware of these connections provides freedom to choose differently, behave more adaptively, and see present circumstances without the distortions caused by painful events in one’s history.

The eclectic therapist uses a combination of therapies (such as CBT and IP). Many therapists, perhaps most, consider themselves to be eclectic.

Medication

People often have strong views about the use of psychiatric medications. Some are huge supporters whereas others see the use of medication to treat depression as a high-risk gamble, or worse, a sign of weakness.

The bottom line is that medication has a long record of being effective in reducing depression in most people.  When used appropriately, antidepressants are extraordinarily safe, although some side effects are possible.

Moreover, they are often used in combination with psychotherapy – for good reason (Read my blog of August 11, 2018 to learn more about when to use medication). These two approaches combined are generally more effective in bringing relief than either approach in isolation. Medication brings about faster change, and psychotherapy brings about more lasting change.

 DEPRESSION ANXIETY TRAUMA PTSD

CONCLUSION

The impact of depression is felt in many families. The good news is there is much that can be done to identify and treat it effectively.  Depression plays tricks with your mind. It makes you believe that life will never get better. That the happiness you once knew has been irretrievably lost. But there is hope, and every reason to expect that one or more of the approaches outlined above will be able to help you turn thing around. Regain the joy and vitality that depression has stolen.

So, if you, or someone you love, has several of the symptoms listed at the start of this blog, consider talking to your physician or a counselor to learn whether it might be time to get some help. There is nothing to lose by taking that first step.

 

 

 

 

When Does Medication Make Sense

medication.jpg

Depression, Anxiety, Medication & You

Depression and anxiety are two of the most common psychiatric concerns among adults, adolescents and children in the USA. The impact of depression and anxiety can be devastating.

Just looking at depression, research from the World Health Organization shows that it is the fourth leading cause of disability. In younger individuals the impact of depression has far reaching consequences. For example, depressed teens are much more likely to become pregnant than their non-depressed peers. Their peer relations are also negatively impacted, as is their ability to prepare for adulthood.

Depressed college students are 60% more likely to drop out of school than their non-depressed peers, and marriages where one spouse is depressed are more likely to end up in divorce.   

Not surprisingly, depression frequently has a profound economic impact. Annual household incomes where one spouse is depressed are significantly less than households that are free of depression.   

The list of problems associated with depression could fill the pages of a book, but I think the picture is clear, depression is a serious problem.

The case is the same when looking at the impact of anxiety (and severe emotional distress in general).  

These statistics paint an alarming picture – having anxiety or depression is not a matter of simply dealing with distressing emotions. Instead it is a matter of dealing with something that can turn your life inside out in a dozen different ways.

When you, or someone you love, has anxiety or depression, some serious decisions need to be made regarding treatment. Living with depression or anxiety for years, or worse, for a lifetime, is a horrible option. The cost is too high.

When faced with anxiety or depression, one needs to decide how to overcome the challenge it presents. Many people turn to psychotherapy as a proven means for bringing about positive change (as an aside, research shows that medication and psychotherapy in general are equally effective, but therapy produces longer lasting results, and medication provides faster results). 

At some point during therapy you are likely to discuss with your therapist the idea that medication could be a help. How can you wisely decide whether this is a road worth travelling down?

The Down Side of Antidepressants and Anxiolytics

When the topic comes up in conversations with those that I work with I find it helpful to focus on the risks versus benefits of medication. For most healthy individuals the risk attached to taking an antidepressant or anxiolytic (medication for anxiety) are minimal.

Even so, some people do experience one or more side effects. These may include nausea, blurred vision, drowsiness, diminished libido, dry mouth, upset stomach, insomnia, fatigue, and a several other symptoms. With anxiolytics there may be the risk of developing a dependency on the drug, and eventual abuse needs to be guarded against.

Of course, the specific side effects and probability of developing these symptoms, varies according to the specific medication. As a psychologist I don’t prescribe medication, which means that my clients need to see their personal physician, or a psychiatrist, to obtain medication and have follow up visits to monitor for side effects.

To summarize, the main cost of taking medication for anxiety or depression includes the possibility of developing one or more of the side effects just mentioned; the time/money required to see a physician, and; the need to follow up periodically with medical checkups.

The Benefits of Antidepressants and Anxiolytics

But what of the benefits?

On this side of the ledger there is one major benefit… and it can be a game changer. Medication can quickly allow someone with anxiety or depression to feel better, and in doing so unleash their potential to benefit even more from therapy.

Keep in mind, severe anxiety and depression robs a person of the ability to fully utilize his or her strengths. The depressed or anxious person is operating under the incredible weight of these disorders, and this means that they have a difficult time tapping into skills that would otherwise allow them to make greater progress.

An analogy may be helpful (stay with me, this will make sense in just a moment). Imagine you just bought a new car and are driving it home on a country road, enjoying the terrific deal you made (and trying to ignore how much the car depreciated once you drove it off the lot). A dog runs out in front of you, and with Dale Earnhardt like reflexes you swerve, artfully missing the little canine but sending your brand-new set of wheels off the road and into a ditch.

The dust settles. You slowly exit the car and carefully examine it from fender to fender. With a dramatic flair you fall to your knees in gratitude and shout out "Not a scratch! Not a single ding!”  But then, looking around, you realize that you, and your car, are not going anywhere.

It may have all the horsepower and all the other wonderful customized features that first attracted you to it, but you are still in a ditch. That car isn’t going anywhere as long as it is in the ditch.

What do you do?

You call a tow truck, which comes and pulls the car out of the ditch, back onto the road. Now all of those features that could not be made use of while the car was in the ditch are available to you again. You say goodbye to the tow truck, and serenely ride down the road.

Medication can function like that tow truck. When anxiety or depression has put you in a ditch so deep that your abilities and skills are not able to be employed, the right medication can help. It can relieve the symptoms enough to unlock your potential to face challenges, think more clearly, develop creative solutions, to persist toward your goals, and to make the most of therapy.

CONCLUSION

When you are faced with the decision of whether to take medication to help with symptoms of depression or anxiety, consider the costs and benefits. One of the best reasons to take medication is that it has the potential to “turbo charge” your psychotherapy by unleashing the skills and abilities that anxiety and depression have kept suppressed. If your depression, or anxiety, is so severe that it has blocked you from tapping into your strengths, cut you off from those abilities that would help you to effectively fight back and overcome these problems, then medication should be 'on the table.' Don't let your fears, or pride, keep you from taking medication.

By the way, I’m not a physician, so none of the above should be considered medical advice. It is, however, the sort of practical advice I’ve seen work well for many many people.

Let me know if you have any questions. Would love to hear from you.

Depression: An Easy Guide to the Signs of Depression and Treatments for Depression

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Today I want to talk with you briefly about depression. Not depression as in “I feel sort of sad today” or “I’m just in a rut”, but rather full-blown depression. The type of depression that robs you of joy, saps you of energy, depletes your self-confidence, disturbs your sleep, and causes you to feel like a Mack truck ran over your soul.

Yep, that type of depression. There is a name for this type of mood disorder, and it is called “Major Depression.”

Other than being extremely unpleasant, why is it important? Because depression not only interferes with living life to its fullest, but also results in diminished work/school performance, a deterioration of physical health, impairment in parenting, increases the risk of financial problems, and in extreme cases leads to suicidal thoughts or even attempts at taking one’s own life.

What’s more, it is more common than many people believe. The National Institute of Mental Health (NIMH) reports that 16 million adults (4% of the adult population, or nearly one of every 20 adults) suffer with a major depression each year.

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For teens the situation is even more sober. The NIMH reports that each year 3 million teens (13% of the adolescent population, or approximately one of every 8 teens ages) are confronted with a major depression.

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I'm sure you are not surprised, after looking at those numbers, to hear that depression is one of the most common problems with which therapists work.

Fortunately, there is a high success rate for depression: the vast majority of people struggling with depression will experience significant improvement if they receive professional help. (Some people with serious depression can do well simply by making some lifestyle changes, but for most people with major depression, therapy and/or medication will be the most effective and fastest road to recovery).

Now here is the troubling part. Many adult, over one third to be exact, do not seek treatment. Sometimes because they do not realize that they are depressed. That is, they have struggled with the symptoms for so long a time that they now consider them to be a normal part of life. Others do not get help because they fear that there will be a social stigma attached to their seeking assistance.

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With teenagers the situation is even worse. Sixty percent of depressed teens receive no treatment.

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This is heartbreaking given the terrific success rate one can expect if professional help is provided.

With all of this in mind I would suggest that you click on the link here to go to a guide that describes the symptoms and treatments for depression. Take a look (it is a three-minute read), it might be just what you need at this time.

Then write me if you like and let me know if this guide was helpful to you.

A Simple Fix For Depression?

Do you get annoyed with headlines that lead you to believe there is a simple solution to some problem with which you are wrestling? I know it irritates me…. And I bet it bothers you as well.

This happens frequently in media reports of “remarkable cures” for medical and psychological problems.  Today we are going to look at an example of a miracle “cure” for depression. Spoiler alert: The take away message is DO YOUR OWN QUICK RESEARCH when reading headlines that seem too good to be true.  

The example I will use is the reporting done on some research that took place last year. The research generated nearly a million page views on the internet. Impressive.

Here is what happened.

Emily Tarleton, a graduate student and researcher at the University of Vermont looked at whether taking magnesium supplements had any impact on depression. She was able to get approximately 120 mildly/moderately depressed adults to be in her study. Half of the group took 248mg of magnesium chloride each day for six weeks. The other half did not. A questionnaire was used to measure levels of depression. The change in depression scores at the end of six weeks was the measure of improvement (the greater the difference, the more depression had lowered). At the end of the six weeks the group that had not received magnesium chloride began to take the supplement on a daily basis. At the end of the next six weeks the improvement of this group was also measured.

The findings were that each group experienced significantly lower depression scores at the end of six weeks of magnesium supplementation.

Does that make sense so far? A nice study that certainly suggests that magnesium may be helpful in reducing depressive symptoms in a fairly short time. Does the study suggest that the depressive symptoms went away altogether? No.

Does the study suggest that magnesium works better than standard medication? No, there was no comparison group of depressed people who were started on an antidepressant.

Does the study suggest that magnesium works better than a placebo (for example, a sugar pill)? No, there was no placebo group to compare.

All of this is understandable. No study is perfect, and this was a graduate student who very likely was trying to do research on a slim budget. It’s a nice little study on an important topic.

Ms. Tarleton did a good job of using the data of 120 people (give or take) to raise interest in the role of magnesium in treating depression. She was, I want to point out, very modest about what the results meant… mainly that this looks promising and more research is needed.

Now, let’s look at what the popular media reported about the study.  From Reader's Digest:

This Mineral Fights Depression—and It’s Cheaper and Safer Than Prescription Drugs

Not a bad headline really. But the writer goes on to misstate what the study found. “Ultimately, Tarleton’s findings suggest that the effects of magnesium are just as beneficial for depression sufferers as prescription antidepressants such as Prozac.” 

Really? We should draw this conclusion even though no comparison Prozac group was in the study? That’s a stretch.

Another outlet breathlessly proclaimed:

Magnesium found to treat DEPRESSION better than antidepressant drugs: New science”

Again, an odd way to sum up a study that did not include an antidepressant comparison group.

Then there is this…

Magnesium in Right Doses Completely Reverses Depression: Breakthrough Study

It is a little baffling. The author did not state that her study showed that “magnesium completely reverses depression.” She did point out that the group taking magnesium showed a meaningful reduction in symptoms of depression. Completely reversed depression? It would have been great had there been such evidence, but that is not case.

Is magnesium helpful to people who struggle with depression? The study we looked at suggests it might be. There are other studies that also would lead me to conclude that magnesium supplementation is a promising method for reducing depression in some people.

Emphasis on “promising” and “some people.”

But the headlines would lead you to a very different conclusion. A conclusion that might lead to you and me to have unrealistic expectations, disappointment, or perhaps even down the path of forgoing more proven effective treatments for depression (such as talk therapy, life style changes, and medication).

Conclusion We need to approach health related articles in the popular media with some caution. Neither disregarding them altogether, nor immediately accepting them at face value. Just taking a few minutes to look at the original source will often help make things much more clear.

I wonder whether there is anything you have read recently where this advice might be helpful?

How to Find The Best Therapist (Part 2)

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Last week we began looking at how to find the best therapist for you. This process can be a bit of a journey. But it is well worth the effort to find the right therapist. Someone with whom you can develop a close working relationship, and who has the knowledge and skills to be of help. A brief recap of last week's post may help:

1.    Interview several therapists

2.    Expect that a therapist will talk with you like a normal human being

3.    Make sure to work with someone who has experience helping people who are struggling                     with the very thing that has caused you to seek therapy

4.    Most importantly, find a therapist that you find to be warm, sincere, and capable (this type               of therapist has the highest level of good outcomes)

Last week I also promised a few more tips to round out the process.  Let’s dive right into these.

ONE: Do not pay too much attention to what degree the therapist has earned (LMFT, LCSW, MD, PhD). Research has shown that there is no meaningful correlation between the quality of therapy and the specific degree a therapist has earned. (I know, sad, because I have a Ph.D.).

TWO: Be certain to ask questions when interviewing a therapist. It’s fine if you want to know how many people they have worked with who struggle with anxiety, depression, trauma, oppositional teens, and so forth.

You are probably also interested in knowing how they go about helping the people with whom they work. That’s a fair question, ask away!

Perhaps you want to know whether they give advice, or do they mainly listen and help clarify issues (leaving it up to you to decide what to do at that point). Does the therapist have books/websites to recommend?

It's reasonable to ask how long it is likely to take before your goals are reached (although an exact answer to that question requires the power of a fortuneteller, a reasonable guess of some type can usually be made).

THREE: Don’t put too much emphasis on how many years a therapist has been in practice. Why? Because research shows that most therapist do not significantly improve their skills after the first five years or so after graduating.

This is not always the case, but it is the norm.

The reason why most therapists stop improving their skills over the years is that they do not engage in the process of systematic and deliberate self-evaluation. This is not a gratuitous criticism of therapists (graduate training doesn’t teach one how to perform meaningful and practical self-evaluation). If you find a therapist that does engage in continuous self-evaluation of his/her performance, and then uses that information to improve his or her skills, that's terrific. Put a star next to their name.

There you go. Honest, it is as simple as that.

Follow these guidelines and you will dramatically increase your chances of finding the best therapist for you. Just to make things easier, I have formatted the tips from today’s post, and last week’s post, into a single checklist.  In case you missed it last week, I will also post again (below) the links to four major therapist directories.  Until next time.

https://www.psychologytoday.com/us

https://www.theravive.com/forcounsellors/sign-up/welcome-page.aspx

https://www.goodtherapy.org/

http://www.christiancounselordirectory.com/

 

How To Find The Best Therapist (Part I)

 Best therapist Folsom Granite Bay El Dorado Hills

Best Therapist For You

Finding a good therapist can be challenging. But even more difficult is finding a good therapist that is also the best therapist for you. In this blog post, and the one that follows, I will give tips that make this search much easier. In fact, if you follow the steps I recommend you’ll be just about guaranteed to find a therapist that works well with you.

Before moving on to discuss these steps it is important to know makes for good therapy. That is, therapy that leads to success. It turns out that this topic has been studied for many years, and the conclusion is pretty clear. The thing that best predicts whether therapy will be successful is the quality of the therapeutic relationship.

More precisely, does a client feel understood by his or her therapist? Does the client feel that the therapist genuinely cares about his/her well-being (i.e., you are not just another client to check off the list)? Does the therapist appear competent and skilled? Lastly, does the therapist have a reasonable plan for resolving the problems with which the client is struggling?

There are other factors that influence outcome, but none of them are nearly as important as the four just mentioned. With that in mind let’s look at how you can go about finding the best therapist for you.

ONE: Interview several therapists. 

You can do this on the phone or with a face to face consult. If you interview therapist in person (I recommend you visit three or four therapists) most will charge for their time. This is money well spent. It could save you weeks, or months, of working with the wrong therapist.

Let each therapist with whom you meet know that you are interviewing them to see if they are someone with whom you wish to work. If this offends them, mark that therapist off your list. It should not offend anyone. If you were having a house built you would interview several architects or contractors: none would be offended. Neither should a therapist find this off putting.

After telling the therapist what concerns you are struggling with, and the goals you have, ask how they would go about finding a solution. In other words, how do they work?

Keep in mind that a therapist is really a coach. Just as someone who plays baseball might hire a batting coach to enhance their batting average. That coach would have a certain approach to helping players become better batters, and could describe the strategy to anyone who was interested. So too with therapists. Look for a response that is clear, spoken in English (not psychobabble), and makes sense.

Pay attention both to what the therapist says and how you feel as you discuss these personal matters. If you go away from the meeting thinking the therapist is someone with whom you can relate, and that his or her answers to your questions make sense, put that person on your list of finalists.

TWO: A therapist who has Experience with what matters to you.

Look for a therapist who has a lot of experience working with the issue with which you are struggling. For example, if you are interested in getting help with marital conflict look for someone who spends a great deal of time seeing couples in marriage counseling. Better yet, go to a website that shows you who, in your area, has specialized training in marriage counseling (https://www.gottman.com/couples/private-therapy/).

Avoid therapist who claim to have numerous specializations. Most therapists will have experience with half a dozen or less areas of emotional distress. If a therapist claims to specialize in ten or more areas, be cautious.

THREE: A therapist that really engages with you.

Find a therapist that talks. I know, sounds strange, but some therapists have been taught that they should seldom speak. It’s a throwback to psycho-analysis wherein the patient would do nearly all the talking and the therapist would nod, grunt, and on occasion provide an interpretation (“Ah, I see. You tell me that you were late for work again. I suspect the real meaning of that pattern of behavior is…  you hate your mother…. Or your father…. Perhaps both!”). The mysterious silent types are great for classic movies, but best avoided when searching for a psychotherapist.

On the other hand, you don’t want a therapist who is a chatterbox. The focus of therapy should be on solving your concerns, not listening to stories of how your therapist’s great aunt once had a similar problem. Therapy requires an interaction, with the focus on the client.

The basic idea is your therapist needs to be willing to genuinely engage you. To do this he or she will need to talk with you, respond to your questions, offer advice and insights. The exact balance of how much talk and how much listening is helpful, well that is up to you (which is another reason to interview several therapists, so you get an up close and personal sense of their style of interacting).

So, when you want to answer the question "Who is the best mental health therapist that has an office near me?", the three steps we just covered are where you should begin. I need to mention that there are other steps you can take as well, and we will cover those next week. 

If you don’t want to wait, however, to begin looking for a counselor, here are four links to some very good therapist directories that can help get you started.

https://www.psychologytoday.com/us

https://www.theravive.com/forcounsellors/sign-up/welcome-page.aspx

https://www.goodtherapy.org/

http://www.christiancounselordirectory.com/

 

 

How To Beat The Blues: Part II

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In last week’s blog I wrote that there are two simple things one can do to fight back against depression. In fact, there are literally dozens of straightforward ways to smack depression in the nose: and this is what you want to do, get angry at depression. Angry enough to see it as an enemy that is stealing your happiness. Robbing you of living life at its best.

But describing dozens of ways to beat depression, all within a single blog post, would make for a boring read. Let’s avoid that trap and focus on two simple approaches (for those of you who would like a more in depth discussion that includes a variety of strategies for overcoming depression consider buying the 10 Step Depression Relief Workbook).

ONE

Get moving! Go for a walk, a run, a trot, even a gallop. Go to the gym and push some weights. Head to the dance studio and tango. You get the idea: exercise.

The beneficial impact of exercise on mood is well-documented. It is one of the simplest ways to begin to overcome the blues, it is available to anyone, and it’s free!

We don’t need to get bogged down by overthinking when deciding on how to exercise. The main thing is to get moving. Push yourself. Not so much that you are about to go into cardiac arrest, or cannot keep your lunch down. No need to go that far in order to derive the mental health benefits of moving your body. But do push yourself to the point that you feel that your body has had to do some work.

How long to exercise? Ideally, 20 to 30 minutes… or longer if you like. If that is too much for you, at least at the start, then make it 10 minutes. The main thing, as Dr. Nike likes to say, is “Just do it!”

You can always add minutes later on. The 10-minute walk will become 15 minutes, and this will later turn to 20 minutes, and so forth. You are building a habit, getting into a routine. The most important thing is to simply get started. The number of minutes you exercise is of less importance than getting some momentum on starting the habit of exercising. You can always experiment with how much time to devote to it later on.

How frequently? Every day would be great. Can’t do that? Not to worry. Begin with three times a week. Less than that and you will not see much impact on your mood. Pro Tip: Mark the time you plan to exercise in your calendar. Make an appointment with yourself. If you do not carve out a dedicated time for exercise, it probably will not happen.  

One last thing to keep in mind. If you decide that walking/running is how you will start to exercise then consider finding a park or other nature area. Studies show that being out in nature decreases depressive symptoms. Of course simply being outdoors will also help you absorb more vitamin D, which in turn may provide a modest boost in fighting depression.

TWO

Set goals, make a plan, execute, achieve.  Depression causes you to feel less competent. A sense of helplessness easily sneaks into one’s life.

Setting and reaching goals is the antidote to such feelings. When depressed people tend to set vague goals, and have equally vague plans for reaching these goals. Consequently, they are much less likely to succeed. This lack of success leads to a deepening sense of frustration and failure, thereby worsening the depression.

How to avoid this trap? Start with small, clear goals. You should be able to write such a goal, and plan, on an index card. For some people with whom I have worked these goals are as simple as getting up by 9:00 AM, showering, and being ready for the day by 10:00AM. For others it has been to grocery shop twice a week, pay the household bills and meet a friend for lunch.

When depression is severe, it is usually best to set goals that take aim at achieving small victories. That might be having a productive weekly routine, or maintaining contact with friends. As the depression begins to retreat, you can take aim at more ambitious goals.

If you are depressed I hope you will give these two easy strategies a try. They might be just the thing that helps you begin to feel better, and build momentum for even bigger changes.

 

How To Beat The Blues: Part I

 Therapy Anxiety Depression Trauma Folsom Granite Bay El Dorado Hills

 

“I’m not sure why I am here” Jason said as he leaned forward in his chair. Then laughing slightly, he added, except my better half insisted. His wife, Laura, was sitting on the couch next to him. After waiting a moment she broke the silence “It’s because Jason just isn’t himself any longer. I don’t know what’s happened. The guy I married ten years ago seems to have disappeared.”

In the following hour I learned that prior to the past year Jason had been a vibrant, engaged, and thoughtful husband. Their two young children were frequently the focus of his attention when he was not at work. As a family they were always doing something together. Camping, travel, game nights, visits with friends: they were an active and happy family.

Family life had changed dramatically over the last twelve months. Now Jason’s interactions with his children were brief and lacking in any emotional connection. Bedtime stories had dropped away long ago, and playtime with the kids in the back yard had been replaced by Jason sitting alone in front of his computer.

Most evenings Jason would remain secluded in his study until others were asleep. He often ran late for work – in the past he had always been the first to arrive at the office. Once at work he became easily distracted and fatigued.

At first, Laura had reacted with concern when these changes in Jason’s behavior had begun. But as the months dragged on, and she more and more took on the role of a single parent, she became resentful as well. Feeling like she had reached the limits of her patience Laura gave an ultimatum.

Either Jason would begin to ‘show up’ as a husband and parent, or she would ask that he leave the house. “You want a divorce?” he had responded.  “No” she replied, “But I do want some space… at least if you’re not going to be here for us. We’ve got to do something. I can’t go on like this, I just can’t.”

That “something” that they decided to do was get marriage counseling. They thought if they could just learn to communicate better then they might be able to rebuild the sense of intimacy and support that they had once enjoyed. Neither Jason nor Laura knew why they had drifted apart, but they felt certain that if they could learn to communicate better they had a chance to turn things around.

The problem with this plan is that they had always communicated just fine. Poor communication was not at the heart of this problem. The real issue was that Jason was depressed. Not just mildly depressed either. He was struggling with a major depression.

He simply did not recognize the symptoms of depression. The things he thought of when that term came up included crying throughout the day and having thoughts of suicide. Although these two features are symptoms of depression, there are many others. In fact, someone can be very depressed and only have a small handful of symptoms. But if those symptoms are extreme, the depression can be devastating.

If you wonder whether you might be experiencing depression I suggest you take the following online test (click here). Although it is not a substitute for the sort of thoroughgoing evaluation you would receive by visiting a therapist, the results may provide helpful insights for you to think over more carefully. That point is worth emphasizing. No single test can determine a psychological diagnosis. So if you take the test and end up with a high score, well, that's something to take time thinking about. But don't jump to conclusions that it means you are absolutely, positively, without a doubt suffering with a Major Depression. 

Next week we will look at two simple things you can do to fight back against depression. You won’t want to miss it (really, you won’t). See you then.

Living Your Best Life By Overcoming Challenges

Somewhere between toddlerhood and adulthood most of us learn to dial back our determination or desire to persist when faced with failure. We become complacent and settle for too little in life. We set aside dreams after failing to reach our goals after the first, second or third attempt. Many of us let the fear of failure keep us from experiencing what life holds for us.