The importance of women having girlfriends, an explanation of emotions to a pre-teen, how to create a balance with chores and child-play, and when to know it's time to change personal therapists.
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“There seems to be an increasing feeling in our society that full-time, all-encompassing happiness is desirable and in fact our right. In our constitution, we are guaranteed the right to pursue happiness, not that we achieve it. ”
"I feel abandoned when my children come to visit me. I live in a retirement home and when they come to visit me from out of town, they sleep here and then leave all day. I just feel like they are on a vacation and using my place a free place to stay. I am so grateful to see them all, I am afraid to say anything. What can I do? I do want them to visit."
Signed 81-year-old mother.
I saw a painting recently of an elderly woman holding a beautifully roasted turkey on a platter. She was standing in the doorway of her kitchen, looking into the living room with a forlorn look on her face. In the living room, her children and grandchildren had their noses in their iPads, laptops, and smart phones and appeared to have no interest in each other or even in her. Time marches on, and things change. How to cross these generational boundaries will involve some reaching and compromise. They need to know, and you need to tell them that you want to spend more real times with them on their visits. Do not sit quietly by waiting for them to notice your sadness. Remember, you may need to compromise on how the time will be spent. Your children and grandchildren are naturally going to be more active and energetic than you. Their interests are different. They may not want to stay at home to visit. This generation is not big on sitting in the living room and visiting.
You'll lose them to cyberspace. They may not want to visit a museum or go to a concert, but make the effort to join them on an outing of their choosing. Some years back I read an article on The 10 Rules of Aging. The first rule was, "Rant, don't whine." I'm not necessarily in favor of ranting, but I surely don't approve whining. Speaking up will do just as well.
"My grandmother used to tell me when I was little, if I was a little down, I should read Mark Twain. Can reading books on humor actually help us be happier and less depressed?"
Signed curious parent.
I have a friend who often borrows movies from me. Lately she's been asking for comedies instead of dramas because she says she needs her spirits lifted. They say "Laughter is the best medicine," and it is a way to offset sadness in our society. One of the latest applications using humor involves our soldiers returning from Iraq and Afghanistan. These men and women are often having to contend with limb loss and the use of prosthetics. Humor is used among these patients to normalize the situation and help put things in perspective. It is an indication of acceptance and the decision to move forward in their lives. Humor is both a way in which to battle pain and an indication that we are succeeding.
"For women, how significant are girlfriends to our mental health? I hear more and more about how important they are as I get older."
There are many reasons female friendships are important in our lives. Friends help us live longer by lowering our blood pressure and heart rate. They bring joy to our lives and solace to our souls. Women understand the balm of commiseration and the comfort of dependability. "If you need me, I'll be there." But the question is why women's bodies have a reduction in stress when they visit with their girlfriends. According to the UCLA Study on Friendship Among Women, female friendship raises our bodies' level of oxytocin. Oxytocin in the presence of estrogen lowers the level of cortisol, the stress hormone. It doesn't work in men, as testosterone counteracts oxytocin. Our body's chemistry can be shown to underlie our life's experience.
"What exactly are emotions? I read that curiosity is an emotion."
Signed 11-year-old Sara.
WHAT IS AN EMOTION?
Imagine this. You are in the backyard, and a snake startles you. You make a scared face, you scream and run away. The latest theory is that emotions are evolved reflexes that respond to a situation with feelings, facial expressions, voice and behavior. Add a nervous system response that makes us able to carry all this out and you have a pretty good idea of what an emotion is.
Our emotions evolved in us as humans but also as individuals. We have a lot of choice in the matter. There are a number of emotions such as disgust, that protect us. It keeps us from eating spoiled food. As a small child, mashed peas might disgust you. You can change your evolved reflex as you grow up to respond with smiles and feeling of pleasure as you gobble them up.
We share emotions with some animals, such as our dogs. They
have evolved reflexes to which they respond with feelings of joy or fear. They bark, run around wildly, and lick your face. They might run away if they are frightened.
Emotions are very susceptible to events in our lives. understanding is essential in controlling our emotions so they don't run away with us. When our feelings of sadness or anxiety won't go away, we go to therapy. We can also be more responsible with feelings such as anger. We learn in our lives that we cannot respond with unbridled anger to hurt others. When I was young I was taught, "Emotions are good servants but bad masters."
IS CURIOSITY AN EMOTION?
We can apply what we learned in the previous answer. I think that curiosity is an emotion that leads to feelings of interest and enhanced learning. When we are curious, we put a look of curiosity on our face. I think that curiosity, as an emotion, is responsible for all the great advances on our planet as well as being the reason for "original sin." A baby's curiosity is fun to watch as it explores its surroundings. Curiosity can get us into trouble. Scientist's were curious about and interested in the atom bomb that eventually gave us bad things as well as good. Einstein said that he was "passionately curious." Like all emotions, we are in charge of our curiosity and where it leads us. The pursuit of knowledge is a cornerstone of democracy, and curiosity fuels that pursuit.
"Is fatigue caused by depression, or is depression caused by fatigue?"
Signed tired Dad.
This is like, "Which came first, the chicken or the egg?" I think that depression causes fatigue rather than the other way around. Fatigue is a primary symptom of depression and often interferes with our ability to fight the mood. It leads to a real conundrum. The depression causes fatigue that makes you too tired to fight the depression. I remember a friend of mine inquiring of her husband, "Are you alright?" She was obviously worried about his withdrawn demeanor. He answered, "I'm fine. Just tired, I guess." How many times have we heard that conversation in our lives? Chronic or unexplained fatigue should always be investigated. If we are suffering from depression-induced fatigue, we will need to treat the depression with medication, therapy, or a combination of both. Fatigue can be treated with good sleep, good food, and exercise.
Fatigue might cause an episode of depression in someone who is prone to the condition. I often tell my depressed patients to avoid extreme fatigue over long periods of time, as this can be a trigger for an episode of depression. But it doesn't cause the depression in the first place. We can be very tired, but happy.
"Can thyroid imbalance really cause depression? How do you know if you have a physical problem vs. a psychological problem?"
Signed 41-year-old mother.
There are many symptoms caused by under-active thyroid that are shared by depression, such as lethargy, changes in sleep and eating patterns and mood. It is important to know that you have both conditions at the same time. If you feel depressed, you should investigate in both arenas. Go to your primary care physician so that he can investigate your possible thyroid condition with blood tests or by checking your symptoms, (blood tests don't always indicate an imbalance). But be aware that you could also have depression that needs to be treated with medication, therapy, or both. The thyroid produces hormones that regulate your energy and mood and can be a factor in depression.
In addition, I would like to comment on our wish to "medicalize" our mental state. "If feel this way because my hormones are out of balance or I'm fatigued or I have PMS or menopause." When the real issue, which we do not want to faec because it involves too much work, is unresolved unconscious issues. Good long-term therapy is hard work; I'll give you that. But I really believe it's worth it. Physical problems of many sorts can trigger anxiety or depression, but the fact remains, more work needs to be done other than taking another pill.
"My father brought me up with a lot of chores and responsibilities. My wife and I are having a disagreement about household chores with our children. She thinks I put too much pressure on them and they are getting overwhelmed and stressed out. I know that times when I was a kid I thought it was unfair for me to have to do so much, but I think it taught me a lot and gave me a good work ethic and helped me really organize my time. What do you think? Kids need to learn how to deal with stress don't they?"
Signed curious father.
A few summers ago, I attended an opera called TEA at the Santa Fe Opera. The composer was Chinese and it was a world premier. The chorus repeatedly sang a refrain that said, "Planting tea is hard. Harvesting tea is harder. Savoring tea is hardest." I leaned over and whispered to my friend, "They've got my number!" Like you, I was raised with lots of chores. I grew up on a dairy farm and as an adult, I have terrific work ethic. I know how to hunker down and get a job done efficiently and with great time management. But I have a real problem with rest, relaxation, and savoring the fruits of my labors. My pleasure in life is WORK, and that's not very balanced.
It seems to me that the key to children and chores is balance. We need to know how to work and play, hanging out under the bridge with our friends and playing in the creek, making up stories and pretending to be heroes and heroines. I did an informal survey of my friends in my walking group, and we all spoke about our childhoods and the chores for which we were responsible. One woman said that in this cybernetic age where on a computer it takes the flick of a finger, children need to learn about process. Process is the how and why chores are done. Washing a dish means getting it clean, not just running it under a faucet. You must look at what you are doing; examine the dish for cleanliness because that is the process of washing a dish. We live in a different time, and the skills necessary for a successful, happy, and productive life have changed. Children have more homework, which can be considered a "chore." They need to be encouraged to develop personal interests such as my niece's 12-year-old daughter who loves animals. She is in a program this summer at the local zoo as an intern. She is learning responsibility, dependability, and compassion. Children need to learn to manage stress, of course, but they already have more stress than we had at their age. Fewer chores with an emphasis on doing them well and then time to be children with nothing to do is a great gift we can give them.
"Does sugar affect bipolar disorder?"
Whenever someone is diagnosed with a mental disease or disorder they need to know what they can do to help themselves. After the obvious task of taking their meds in compliance with what was ordered, seeing their therapist regularly and learning as much about their condition as possible, what else can they do? With bipolar disorder it is often suggested that the person avoid stimulants, as it might trigger the onset of a manic episode. Sugar in all its many forms is a stimulant, as is caffeine, and if you put the two of them together with a little carbonation and then drink 5 or 6 cans of it a day, you have an obvious problem. We love sugar as an afternoon pick-me-up or a morning wake-me-up, at least for a little while until it drops us over the edge of an emotional cliff. So, little or no sugar or caffeine is the order of the day. The drugs used to treat BPD often cause weight gain, which is the second reason to avoid sugar. The stimulating effects of sugar come and go quite rapidly, often simulating a roller coaster ride or the rapid cycle of BPD. It feels at first as thought it's helping, and the patient is tempted to use sugar to self-medicate, which starts a vicious cycle. The beginning of a manic episode feels good. One has lots of energy and motivation and a false sense of wellness. It's hard to want to avoid feeling that way, but i's only the precursor of a full-blown manic episode, with all the accompanying distressful symptoms. Moderation in all things, especially stimulants, should be practiced.
"How do I know if my family is happy? is there any way to measure happiness?"
Signed curious father.
Years ago I taught in a school of nursing here in Santa Fe. One of my courses was titled Mental Health in Nursing. We had only a couple of psychiatrists in town at that time and the most recent arrival was Dr. John from the Jung Institute in San Francisco. I asked him to speak to my student about mental health issues, such as happiness, and he told them, "Life is not happy. Life is a series of happy moments, and mental health is the ability to enjoy them when they come along."
There seems to be an increasing feeling in our society that full-time, all-encompassing happiness is desirable and in fact our right. In our constitution, we are guaranteed the right to pursue happiness, not that we achieve it.
But how can you tell if your family is happy, and is the happiness of the right sort? Is it simply because they talked you into buying them the latest electronic or shoes, or whatever? Perhaps that is the most important part of this question. What is the right sort of happiness in our world at this time? There is no completely correct answer, but it's a question we should all be asking ourselves. The closeness of a family is one of life's great gifts. Is your family close? Do they enjoy one another and are they there for one anther, in time of need? I think that the ability to relate is essential for happiness within a family and later for children with families of their own. But as I've said, it all depends on the way you measure happiness, money, love, or shoes?
"My 13-year-old daughter has been wearing too much makeup to school. Even her friends are commenting that is is too much. Is this a sign of low self-esteem?"
Signed concerned mother.
Sometimes I think that the majority of teenaged girls suffer from low self-esteem. Hormones are changing, skin is oily and prone to pimples, and worse. Girls can hide behind makeup as though it were a mask. At the same time, it's a sign of being grown-up in adolescence. I realize that your daughter is wearing too much makeup, but please don't overreact. It might make matters worse. Perhaps a visit to a department shore she likes, where she could have a makeover with someone young and hip? That might give her instruction in a more appropriate makeup regime.
In addition, you could address the problem of low self-esteem. I know that I must sound like a broken record, but there's always therapy. Therapy is not always about illness but can address issues of self-understanding and personal growth. A younger therapist might be especially appropriate. Encourage her in the pursuits that interest her. Who knows? She might become the next head of makeup for Warner Brothers!
"I have had the same therapist for the last two years, and I just don't feel like we are getting anywhere. Do I need to find another therapist, or is it just me?"
Signed frustrated mother.
If you've been seeing the same therapist for two years and you feel stalled, you need to discuss this with her/him. Sometimes it does mean you need to move on, but it is more often resistance. Resistance is a defense against going deeper and asking the really tough questions. Therapy is often hard work, and the work is overcoming resistance. It feels like that's what you describe as "not getting anywhere." Pay more attention to your dreams and to what you don't want to talk about rather than what you do. We can all chatter on about what happened during the past week, but what did you think about? What's been on your mind? Flashes of memory that show up as you're driving to work, connections between then and now. What does this remind you of? It's a richer life when you look with a broader vision that encompasses more than just the moment. I know that sounds like a contradiction when we constantly hear about living in the moment. Enlarge your moment to include the entirety of who you are, have been, and hope to be, while living in the moment. Sometimes keeping a journal of your thoughts helps in the therapeutic process. Not a journal of external events but a journal of your internal dialogue. Have you heard of "morning pages"? It consists of writing for a half hour every morning, whatever comes out of the end of your pen. Give your unconscious a chance to communicate with you. It will help in your therapy and help you get unstuck.
-Romona Scholder, M.A., RNCS, Psychotherapist