Category Archives: Ask Ellen Anmuth Psychotherapist

Depression on Easter Sunday

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“Ask Ellen Anmuth Psychotherapist” is a series dedicated to readers’ questions on topics such as depression, anxiety, anger, relationships, communication, conflict resolution, grief/ loss/bereavement, genetic counseling, medical problems, and stress management.  Today’s blog is focused on depression associated with holidays.

Amy from Maine writes: “Dear Ellen Anmuth, Psychotherapist: Today is Easter Sunday, and I am feeling very depressed. I moved to Maine last October from San Diego. My family and life-long friends live in Southern California. This is the first Easter in a new place. I have been feeling depressed all week, and today was a very hard day. Please help.”

Ellen Anmuth, Psychotherapist writes: Dear Amy: Relocation to a new place can be a very difficult adjustment. When I read that you moved from Southern California in October of last year to Maine, that means that you experienced a very cold and challenging winter season. In addition, the sun sets earlier in Maine than Southern California. People who change their locations may have a condition called Seasonal Affective Disorder, related to reduced sunlight exposure.

Depression can be triggered by other factors, as well, such as a holiday spent away from family and friends. Was this your first Easter Sunday spent without these familiar faces?  Was Easter Sunday usually a day of spiritual and emotional comfort?

Finally, relocating your home involves loss and adjustment. Some people focus only on the positive aspects of a move, and try to keep up a happy face, in spite of feelings of sadness and loss. Attempting to deny the feelings of loss can create more feelings of depression. There is an expression, ‘what we resist, persists’. By talking about feelings of loss, we become more empowered to cope with the challenges. Speaking with a Licensed Mental Health professional can also be of help. Easter Sunday, Thanksgiving, Christmas, birthdays, and anniversaries of deaths can all trigger depression. Creating a support group of friends during holiday times can help to avert severe depression. It took much courage for you to relocate across the country. Sometimes it takes equal courage to reach out for help and support during the difficult times. It is wonderful that you were able to write this email. If you continue to seek local support within your community, you will find the transition to Maine easier to adapt to.

 

Feeling Upset? 3 Quick Tips for Getting Happier

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This blog answers emails from readers. Today’s email comes from Jennifer in Kansas City.

Jenifer asks:Dear Ellen Anmuth, Psychotherapist: I find myself feeling upset lately. Do you have any advice? Thanks very much.

Ellen Anmuth, MS, MSW, LCSW, Psychotherapist replies:

Dear Jennifer: Your question is universal. “Getting Upset” is a common phenomenon. By “upset”, do you mean  that you feel angry, sad, or afraid? Do you experience behavioral changes, such as sleep disturbances, over-eating, not eating enough, yelling at other people, using drugs or alcohol? Here are 3 tips for dealing with “feeling upset”.

Tip #1: Look inward, and try to name your feelings. By “Upset”, do you mean that you feel sad, angry, afraid, or all  3? Sometimes, when people feel angry, it could be that they are feeling sad, and are not allowing those feelings to be acknowledged. Similarly, people can feel sad, when they are denying feelings of anger. There is an expression, “what we resist, persists”. One way to manage “upset feelings” is to isolate the feelings, and connect with them. By allowing our true feelings to be expressed, we gain some control over them.

Tip # 2: Notice what events may have occurred in your life in the past year. Did someone you love get ill, or die? Have you had a relationship breakup? Are you having financial problems? Is your health changing? Some of us try to cope with sadness or loss by minimizing these events. It is better to acknowledge the events, and work the feelings of loss through with a friend or a licensed psychotherapist.

Tip #3: Look back to your family of origin history and your childhood. In adulthood, seemingly benign events may trigger unresolved issues of childhood. For example, if you had a very controlling mother or father, a boss at work may trigger some unresolved feelings from years ago. Feelings of helplessness or powerlessness in the workplace could result in depression, anxiety or anger.

Hopefully, exploring these three areas will help turn the general concept of “feeling upset” into a situation in which you can more clearly define and describe the real issues that need to be addressed. This leads to a feeling of control and well-being when a breakthrough in understanding and coping can be achieved.

How to Hold it Together When You Are Coming Apart…Or, It Just Feels That Way

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“Ask Ellen Anmuth Psychotherapist” is an ongoing feature of this blog, “TheLanguageOfSolutions.com/blog”. Readers’ questions  are answered when they have a broad appeal. Samantha is dealing with  universal issues of grief, loss, change and feeling overwhelmed, depressed and anxious.

Samantha from Texas writes: Dear Ellen Anmuth, MSW, Licensed Psychotherapist and Genetic Grief Counselor:

I have been dealing with many changes in my life. A new job has required me to relocate to another state, away from family and friends. In addition, I need to buy a house, pack and move. I feel overwhelmed with all the details. I am becoming depressed, and the more depressed I get, the more I feel scared that I am in a downward spiral. Please help me cope with all the things I am facing, as I am not holding it together very well. I cannot seem to concentrate as well as I used to.

Ellen Anmuth, MSW, Licensed Psychotherapist:  Dear Samantha: I am sorry to hear that you are feeling depressed, anxious and overwhelmed by the stress of a new job, new location, needing to buy a house, pack, move and handle all the paperwork and details of that relocation.

A home relocation is a giant task…a new job is also huge…buying a new home and moving out of state is monumental.  Feeling overwhelmed by the enormity of the tasks is normal.

One solution to getting control of the feelings of depression and anxiety may be revealed in a strategy called compartmentalization.  Here are some techniques that can help:

1) Become aware that there are emotional tasks, intellectual tasks, and physical tasks. Some people believe that there are also spiritual tasks. It may be helpful to begin to write in a journal. log book or diary, creating a section for each topic above.

2) Once you have made entries in your log book related to these different “task” areas, create another sub-section where you write down your emotions related to each area. The exercise of naming our emotions and writing our thoughts and feelings about them may create a sense of catharsis and control. In addition, this exercise may identify topics and areas of your life in which seeking support would be helpful. The support can be in the area of professional counseling, reaching our to friends, or other resources in your community.

3) Years ago, I was a Grant Writer. Faced with this gigantic task, I would make an outline, including goals, objectives and action steps to achieve each goal. For anyone facing a major life move, breaking down each big task into smaller “mini-tasks” can provide two things: (a) a road map of what to do first, second and third, and (b) emotional relief over some feelings of stress, in that the trail to follow has been mapped out.

4) Stay Flexible to Change Course: Anything can pop-up along the way that is unexpected. It is best to “expect the unexpected”, so that road blocks encountered can be experienced as expected steps, not as scary surprises.

5) Honor Feelings of Grief and Loss: Even when a relocation is expected and hoped for, such as a desired new job, feelings of sadness and loss will likely come along. Saying goodbye to friends and local family is very challenging. Finding a good therapist who understands the grief process can be helpful, (Remember that not all losses and grief processes involve an actual death, but rather, separations and change.)

Samantha, I hope these strategies help during your time of transition.

 

Ask Ellen Anmuth, Psychotherapist: Coping With A Cancer Diagnosis

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Ask Ellen Anmuth, Psychotherapist

Ask Ellen Anmuth, Psychotherapist

A cancer diagnosis can be terrifying. The journey can begin with a swollen lymph node, a breast lump discovered while showering, or a visit to the doctor, where the words “we need to get this biopsied” reverberate in you head in stunned panic.

This blog series answers email questions from readers. Robin from Westchester, NY writes:

Dear Ellen Anmuth, Psychotherapist: I had a mammogram a month ago, and was called back for another scan, because they found something that concerned them. Yesterday, I went back for a repeat scan, and they found some abnormality…not sure, but I think they said something about calcification. I set up a biopsy for next week, and I am really afraid that this may be cancer. Please help me.

Ellen Anmuth, Psychotherapist: Dear Robin….It is normal to feel anxiety when told that you need a biopsy. The fear of cancer looms heavy when told that we need to do a biopsy, which is an invasive procedure. Let’s outline some approaches:

1) You live in Westchester, NY which is very close to New York City, with some of the best Medical Schools and Universtiy Medical Centers in the world. Many people like to take their mammogram scans to a University Medical Center, and get a second opinion. You may even want to get another mammogram at the medical center in New York City, and get a second opinion from a specialist in this area. Often times, the University Hospitals are aware of the current research, and if you find a world renowned expert in the diagnosis of breast cancer, you may feel more comfortable. It would be a shame to undergo a biopsy if an expert has an opinion different from  your community doctor. Of course, you can always get a third opinion if the first 2 doctors disagree.

2) Let’s look at some emotional coping skills. First, a cancer diagnosis is no longer is a death sentence. There are many approaches to breast cancer, and treatments are improving all the time. Even in a serious cancer diagnosis, there have been people who have defied the odds, and survived. Dr. Bernie Siegel wrote a book called “Love, Medicine and Miracles” in which he documented cancer patients who told their doctor that they were not going to die, and survived. Remember….the journey of a possible cancer diagnosis is a challenging one, and yet if you are open to support, the journey can be easier. The hospital social work services department can refer you to cancer support groups and licensed mental health providers who can help.

One approach emotionally is to “stay in the moment” and notice if you are visualizing a disaster scenarios. If you start to imagine death and pain, stop and ask yourself if there is fact to support your catastrophic images, or just your fear. Yes, fear is understandable, but try to manage the tendency to imagine the worst. Think back on your family of origin coping skills. Did your parents have a pessimistic tendency, always jumping to the worst possible conclusion? Or, did they tend to be optimists or realists? Reflecting on some automatic patterns you may have learned can be helpful. Finally, some people like to seek religious and/or spiritual support, and find comfort by doing so. Remember that current crises can bring up some repressed memories of past unresolved issues. A licensed mental health professional can be of help with coping with the wide array of issues that emerge when faced with a possible cancer diagnosis.

Ask Ellen Anmuth, Psychotherapist: PTSD and the Trayvon Martin Trial

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This blog series was designed to answer questions from readers. In keeping with the current news, a young man named Sam writes in. His  brother was murdered in a violent crime with a handgun, and the news about the Trayvon Martin trial has triggered many feelings of distress.

Sam from Detroit writes: Dear Ellen Anmuth Psychotherapist: My older brother was killed about nine months ago in a violent crime  with a handgun. I am too upset to go into all the details about his murder, but all this news about the Trayvon Martin case has caused me alot of suffering again. I was getting to the point where I could block out some of the bad memories, but all this news about this case on TV has made me remember alot of things that I am trying to forget. I am jumpy, have trouble sleeping, feel angry most of the time, and cannot seem to stop the bad memories. I think they call them flashbacks. Can you help? Thanks, Ellen.

Ellen Anmuth, Psychotherapist writes: Dear Sam, I am so sorry to hear of this tragedy in your life. Yes, you are right when you call the bad memories “flashbacks”. Sometimes, when we have experienced a trauma, like the violent murder of someone we love, recurrent thoughts, feelings and visualizations may recur. There is a phenomenon called “Post Traumatic Stress Disorder” that you may be experiencing. Would you be open for seeking some professional help to  better cope with this loss? If you call the social services department of a local hospital, they may be able to refer you to some help… either free help, or with a sliding scale based on your ability to pay. With the proper counselor, you could be helped to work through this very complicated bereavement process. I will explain more below.

I use the word “complicated bereavement” because it contrasts with “uncomplicated bereavement”. All deaths involve emotions and thoughts for most of us. For example, if a very elderly person dies of natural causes, and you had a happy relationship, you will grieve, but will likely not be tormented. On the other hand, if a young person is murdered, the survivors are left with a “complicated bereavement” process, needing to work through a series of complicated thoughts and feelings. For this reason, finding a licensed counselor who specializes in complicated bereavement processes would be a helpful strategy.

 

Ask Ellen Anmuth, Psychotherapist: Coping With Financial and Health Stress

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This article series addresses questions from emails. Today’s topic is “Coping With Financial and Health Stress”.

Anthony from Brooklyn, New York writes: Dear Ellen Anmuth, Psychotherapist: I am a waiter, and have to share an apartment with another guy, because I cannot afford a rental on my own. I am 21 years old, and wish I could afford my own place. I would like to go to school at night, to get a BA in Criminology, but I do not know how I could afford it. Any ideas how to cope with this stress and worry? I am having trouble sleeping.

Ellen Anmuth, Psychotherapist: Anthony, I can understand how financial stress can affect your life. However, the positive that I read in your email is that you have a desire to go to school to study Criminology. Have you identified a school that you would like to attend? In the New York City area, there are likely many colleges that offer that training. Perhaps you could contact the Admissions Office, and inquire about any student advisory services that may be able to help. In addition, there are usually financial aid departments, who may know of scholarships to help you get through school.

Regarding your sleep problems, anxiety and depression can cause sleep disturbances. If you contact the Social Services Department of any local hospital, they will be able to provide a list of agencies that offer counseling at a sliding scale to help you learn to manage the stress more effectively. I know many people who have had jobs and have also gone to school at night. As a waiter, perhaps you could attend day classes, and wait tables at night? If you are creative and flexible, you can create a schedule that works well for you. Keep the vision of your goal, and that will help you through the stressful moments. Also, if you contact Police Departments, they may have ideas of how you might find scholarships for your education.

Beverly in Colorado writes:  Dear Ellen Anmuth, Psychotherapist: I am trying to cope with an elderly mother who is declining. She is 72 years old, and is dealing with a new diagnosis of Leukemia. I am fearful of the course of this illness, and how I might cope with this, and be of help to her.

Ellen Anmuth, Psychotherapist:  Beverly, there is a national organization called “The Leukemia and Lymphoma Society”, and their website is LLS.org.  They provide information regarding  Leukemia and other blood cancers. Experts are available by phone who you could speak with to learn more about this disease. They also know about  community resources  to help you cope better with the stress of this illness in your family.  Good luck with this challenging issue. Make sure that if you are a caregiver of your Mom, you also find time to take care of yourself.

Ask Ellen Anmuth, Psychotherapist: Dealing With Feelings of Isolation

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“Ask Ellen Anmuth Psychotherapist” is a series in which people send questions via email to Ellen Anmuth, Licensed Psychotherapist, and each month, a few  emails are selected for this blog series. Today’s topic is “Dealing with Feelings of Isolation”.

It is a very interesting time in history. Why are people feeling lonely, when the technology seems to connect people through social media? For example, people may have “Facebook Friends” who they have never actually met. The definition of “friendship” has been altered recently, to include strangers, perhaps loosely connected by business or by friends of friends. It is not surprising that people tell me that they feel disconnected, when they live in an illusion of being surrounded by “friends”.

If someone has  Facebook friends, followers on Twitter, or connections on Linkedin or on Google Plus, they may be feeling an undercurrent of loneliness, despite the illusion or appearance of connections. Additionally,the written Internet language has been reduced to micro abbreviations, and text messages have replaced phone calls for many. To what extent are deep emotions communicated digitally? Is “LOL” the mainstay and epitome of emotional expression? I think that the “glue” of relationships is  shared activities and the exchange of stories and deep feelings, to name just a few elements.The Internet often makes that difficult.

On the positive side, the social media does provide the potential for people to meet in person or on the phone, and to develop business and/or personal relationships. However, more often than not, if a person has 20,000 twitter followers, there is clearly not a connection with many of them.

How can people in this age of digital connection, address the sense of isolation that emerges from the lack of personal contact?

Diane from Ohio writes: Dear Ellen Anmuth, Psychotherapist: I have recently moved from the San Francisco Bay area to move to a small town in Ohio to take care of elderly parents. I miss my good friends and the vibrant, intellectual atmosphere of a big city, and I am feeling isolated here. I find it difficult to make new friends, and develop intellectual companionship. Any ideas?

Ellen Anmuth, Psychotherapist: Diane, you are dealing with many losses: It is likely that you are grieving San Francisco, a vibrant city with much culture and your group of friends. Allow yourself to go through a grief process, acknowledging the loss. Perhaps a grief and bereavement group may be helpful. In addition,    do you have hobbies and interests that you could get involved in? There is a website called Meetup.com, where people can search  for groups in their city, and you may find like-minded people. Many public libraries have discussion groups that you can sign up for. If caring for your elderly parents is taking up most of your time, could you hire a nurse part-time, so that you could develop new relationships and connections? Moving to a new town involves many adaptive tasks, and staying positive and optimistic is the first step toward bringing more friends into your life.

 

 

Ask Ellen Anmuth, Psychotherapist – ABC TV’s “Shark Tank” as a Metaphor for Faith and Control

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In What Way is the ABC TV show “Shark Tank” a Metaphor for Faith and Control in Business Marketing and Development?

This series, “Ask Ellen Anmuth, Psychotherapist”, is devoted to addressing emails from readers.

SANDRA FROM INDIANA WRITES: I work in the field of spiritual coaching, and I find myself watching “Shark Tank” from a perspective of spirituality. In other words, I feel that people who come to the show have a dream that they wish to manifest. They seem to have some degree of control, but when they get into the “Shark Tank”, they do not know how the panel of “Sharks” will respond to their idea. Can you comment on the issue of control and spirituality related to business development?

ELLEN ANMUTH, PSYCHOTHERAPIST: I appreciate this very insightful question, Sandra. I think that the TV show, “Shark Tank” has become very popular because it taps into some of the core issues for individuals with a dream of building and promoting their own product or business. What does it tap into?

Perhaps the core issue is “Control”. The notion of “control” is a fascinating one to ponder, on many levels…practical business, spiritual and psychological.

On the TV show, “Shark Tank”, we have seen some people present their ideas with great confidence, only to find out that they are unprepared to answer questions about the nuts and bolts of the finances related to their product. Others come in very prepared financially, and yet seem to present with an air of arrogance that offends the “Sharks”.  When people have business dreams, what causes some deals to click, and other deals to fail?

An aspect of success in business promotion may be that subjective element of “right place, right time”,  and an aspect of the blending of personalities of the business owner and the business investor. What other elements are operating on both conscious and unconscious levels between people negotiating a business deal? What aspects of verbal and non-verbal communication contribute to outcomes? 

To what extent to we have control over a business situation, despite the best intentions to plan and prepare? To what extent do we have control over any interpersonal interaction?

Some Aspects to consider:

1) Did you ever feel totally prepared and confident, and find out that a presentation did not go your way? Did the opposite ever occur, in that when you are hardly trying at all, things click and unexpectedly positive things happen?

2) Do you believe in a spiritual component to business?

3) Do you believe in fate, in that if one door closes, it is because something better is around the corner?  I appreciate any comments on the topic of spirituality, control and business outcomes.

Ask Ellen Anmuth, Psychotherapist: How Can I Lose Weight, Even Though I Travel?

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This article series deals with email questions sent from readers. Gary from Boston travels regularly for business, and is gaining weight. He writes:

Gary: I travel at least 4 days per week for business, and stay at different hotels each night. In the last 2 years, I have gained about 25 pounds. I find myself alone in the hotel room after 8 PM, eating junk food while I watch TV. Do you have any advice?

Ellen Anmuth, Licensed Psychotherapist:  Traveling for business can be stressful. You write that you are eating junk food at night when you are alone in the hotel room.  Some people reach for food when they feel lonely. If you are eating out of a feeling of loneliness, perhaps you could find ways to manage those feelings that do not include food. How about calling some friends when you are alone in the room?   I am assuming you have already had dinner, and you are eating out of emotional hunger, rather than biological hunger.

If you are over-eating to calm anxiety, perhaps getting in touch with what is creating the feelings of anxiety could be helpful. Once you identify what is causing the stress, you could develop an action plan to reduce the anxiety.  

Finally, perhaps you could bring in some low calorie snacks into your room that give a crunch, such as celery or carrots, if you enjoy crunching. Keeping an apple or orange in the room is also helpful, and lower in calories than the candy bars or other junk food you are alluding to.

Although you did not mention food selections at restaurants, there are things you can do when you eat out that can lower calorie intake. For example, baked foods are less calories than fried foods. Given an option, ask for side orders of salads and steamed vegetables, which are very filling. Try to limit the amount of salad dressings and high calorie desserts.  Hope this is helpful, Gary.

 

Ask Ellen Anmuth, Psychotherapist: Reduce Stress in College

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“Ask Ellen Anmuth, Psychotherapist”  is a series of blog entries by Ellen Anmuth MS, MSW, LCSW,  a Licensed Clinical Social Worker. Select emails will be answered which may appeal to a broad audience.

This blog does not replace mental health counseling services, and I strongly recommend seeking the help of local licensed mental health providers when indicated. The Social Work Services Department of most hospitals can be a helpful referral source, especially if financial need is an issue.

This article will deal with two different topics from Sharon in Texas and  Don in California.

Sharon S. from Texas: “I find myself seeking approval from my family. They tend to be very controlling and critical, and I am afraid to make a decision that they may not approve of”.

Ellen Anmuth MS, MSW, LCSW: Sharon, I see that you are 20 years old, and living at home while attending community college. This can be a difficult period of life for you, in terms of a concept called, “separation-individuation”. You are in a period of life that some therapists call “The Young Adult Transition”. There are certain developmental tasks in each period of adult life, and stress can result when our inner compass differs from parents’ views.  Do you have friends you can relate to, and who share your values? What type of things do your parents disapprove of?  Are you engaging in any dangerous activity that would support their concern, or do you feel that their controlling behavior is related to treating you like a teenager, rather than a young adult? Sometimes, if parents have a difficult time adjusting to an adult child’s need for separation and individuation, conflict can emerge. Perhaps there might be counseling services through the community college, where you may be able to meet with a licensed therapist in person, to better evaluate the situation and guide you through your options and coping strategies.

Don M. from California: “I am pre-med, and so anxious about my tests that I can’t concentrate to study, and my grades are suffering. Do you have any ideas how I can study when I have so much anxiety about failing?”

Ellen Anmuth MS,MSW, LCSW:  Don, this is a question that so many others have asked me. I have an Education degree, and was an Assistant Professor of Family Medicine, teaching  medical students and doctors about psychology and education. I developed a technique to help people deal with test anxiety that was blocking their concentration. Try this: Take a sheet of paper, and make two columns: 1) The advantages of holding onto the feeling of anxiety, and 2) The disadvantages of holding onto the feeling of anxiety.  Fill out both columns quickly, writing the first things that come to mind. You will see a pattern, which will reveal information that may provide some insight. You may find that there is no logical “advantage” of holding onto the feeling of anxiety! That realization helps us to compartmentalize it away, at least temporarily, in order to concentrate.

Another useful technique is to make a “contract” with yourself, that every day, from 8pm-10pm you will study the course material that worries you the most. Do an “imagery exercise”: Imagine putting the feeling of anxiety in a box that you can put away (metaphorically speaking). You may imagine putting a box with your anxiety on a shelf in your closet, where you can close the door, so that with your anxiety “away” for the few hours, you can focus on the subject matter. After 2 hours, if you want to find that box, open it up, and experience the feeling of anxiety again, you can. You have that control. However, after 2 hours of focused study, you may find that the anxiety can stay in the closed box, and that you feel more confident and relaxed!  In fact, you may decide to throw that black box with anxiety out into the trash, rather than keep it on your closet shelf. This is a guided imagery exercise, which may be helpful. With incremental hours of successful concentration, you will feel more in control, and more confident about passing your tests.